Individual
PATRICIA BLAKELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
251 CAJON ST, SUITE B, REDLANDS, CA 92373-5260
(909) 793-7500
(909) 798-2411
Mailing address
251 CAJON ST, SUITE B, REDLANDS, CA 92373-5260
(909) 793-7500
(909) 798-2411
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G66318
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G663180
—
CA
Enumeration date
08/19/2006
Last updated
12/02/2011
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