Individual
ANDREW BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 256-4673
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
(626) 775-3514
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A147398
CA
208600000X
Surgery Physician
LP01881
RI
Other
Enumeration date
05/11/2010
Last updated
07/21/2022
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