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Individual

DONOVAN C BLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5196 HILL RD E STE 300, LAKEPORT, CA 95453-6374
(707) 263-6885
(707) 263-6624
Mailing address
5196 HILL RD E STE 300, LAKEPORT, CA 95453-6374
(707) 263-6885
(707) 263-6624

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C151877
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000377241
ANTHEM
KY
01
2646385000
PASSPORT ADVANTAGE
KY
01
50008747
PASSPORT
KY
05
64113251
KY
Enumeration date
03/14/2006
Last updated
10/24/2025
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