Individual
AMANDA L BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 256-4673
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
20A16427
CA
Other
Enumeration date
04/04/2015
Last updated
05/06/2021
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