Individual
DR. DAVID MICHAEL BLACKLOCK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 HAWTHORNE AVE, OAKLAND, CA 94609-3108
(510) 655-4000
(510) 658-8593
Mailing address
3173 MIRANDA AVE, ALAMO, CA 94507-1610
(415) 515-4960
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A95723
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851503593
—
CA
Enumeration date
05/04/2007
Last updated
12/21/2022
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