Organization
DERMDOCS
Active
Other names
Portrait Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK BLAKE MD (CHIEF MEDICAL OFFICER)
(858) 375-3653
Entity
Organization
Contact information
Practice address
1022 N EL CAMINO REAL # 134, ENCINITAS, CA 92024-1320
(858) 293-1152
(858) 780-5287
Mailing address
12707 HIGH BLUFF DR STE 350, SAN DIEGO, CA 92130-3003
(858) 293-1152
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/05/2022
Last updated
08/18/2022
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