Individual
BLAKE EUGENE HOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10710 N TORREY PINES RD, LA JOLLA, CA 92037-1035
(858) 554-8080
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 554-8080
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61923
CA
Other
Enumeration date
09/05/2022
Last updated
11/08/2022
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