Individual
AUDREY BLAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
F.N.P
Contact information
Practice address
751 MEDICAL CENTER CT, CHULA VISTA, CA 91911-6617
(619) 502-5800
Mailing address
1535 NORTHRIM CT UNIT 258, SAN DIEGO, CA 92111-7338
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21933
CA
Other
Enumeration date
04/05/2013
Last updated
09/04/2021
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