Alban, Blake M
Alban, Blake M is an individual health care provider with primary practice located at 11318 National Blvd , Los Angeles CA 90064-3727. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Alban, Blake M can be contacted via phone (310) 231-9150.Contact Information
Primary practice address
11318 National Blvd
Los Angeles CA 90064-3727
Phone: (310) 231-9150
Fax: (310) 268-9319
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A74491 | California |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A74491 | California |
Profile Details
| NPI number | 1619980406 |
|---|---|
| LBN Legal business name | Alban, Blake M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Jan 3rd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619980406 | NPPES |
| California | MEDICAID | 00A744910 |
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