Blackwell, Craig
Blackwell, Craig is an sole proprietor health care provider with primary practice located at 1667 Dominican Way Ste 130, Santa Cruz CA 95065-1529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Blackwell, Craig can be contacted via phone (831) 462-9225.Contact Information
Primary practice address
1667 Dominican Way Ste 130
Santa Cruz CA 95065-1529
Phone: (831) 462-9225
Fax: (831) 462-6285
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | G52516 | California |
Profile Details
| NPI number | 1326041195 |
|---|---|
| LBN Legal business name | Blackwell, Craig |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2005 |
| Last updated | Aug 26th, 2008 - about 16 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 | 1326041195 | NPPES |
| California | MEDICAID | 00G525160 |
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