Individual
PATRICK W BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 WASHINGTON ST, SUITE 502, SAN DIEGO, CA 92103-2231
(619) 542-0013
Mailing address
501 WASHINGTON ST, SUITE 502, SAN DIEGO, CA 92103-2231
(619) 542-0013
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A130951
CA
207N00000X
Dermatology Physician
P3510
TX
Other
Enumeration date
03/25/2010
Last updated
01/18/2017
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