Individual
DR. FRED BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 OTIS DR, ALAMEDA, CA 94501-5786
(510) 748-0940
(510) 748-0926
Mailing address
1600 SHERMAN ST, ALAMEDA, CA 94501-2236
(510) 748-0940
(510) 748-0926
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
G15873
CA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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