Individual
DR. GARY DAVID BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8010 FROST ST, SUITE 402, SAN DIEGO, CA 92123-2778
(858) 565-8100
(858) 565-8200
Mailing address
8010 FROST ST, SUITE 402, SAN DIEGO, CA 92123-2778
(858) 565-8100
(858) 565-8200
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
G44807
CA
Other
Enumeration date
11/23/2005
Last updated
03/27/2012
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