Individual
BLAKE C O'CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
28069 DIAZ RD, SUITE A, TEMECULA, CA 92590-3465
(951) 676-4325
(951) 676-0097
Mailing address
28069 DIAZ RD, SUITE A, TEMECULA, CA 92590-3465
(951) 676-4325
(951) 676-0097
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC24188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0241880
BLUE SHIELD
CA
Enumeration date
10/11/2006
Last updated
07/30/2010
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