Individual
JUDITH M BLAZUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2725 CAPITOL AVE, SUITE 404, SACRAMENTO, CA 95816-6004
(916) 262-9456
(916) 262-9460
Mailing address
10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 95827-2539
(855) 771-0335
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
G63152
AR
207Y00000X
Otolaryngology Physician
Primary
G63152
CA
207YS0123X
Facial Plastic Surgery Physician
G63152
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G631520
—
CA
Enumeration date
08/13/2006
Last updated
07/10/2015
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