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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326041195 NPPES
California MEDICAID 00G525160

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