Blake, Andre Anthony
Blake, Andre Anthony is an individual health care provider with primary practice located at 2 W Fern Ave , Redlands CA 92373-5916. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Blake, Andre Anthony can be contacted via phone (909) 793-3311.Contact Information
Primary practice address
2 W Fern Ave
Redlands CA 92373-5916
Phone: (909) 793-3311
Fax: (909) 335-4190
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA16708 | California |
Profile Details
| NPI number | 1588655682 |
|---|---|
| LBN Legal business name | Blake, Andre Anthony |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Feb 3rd, 2020 - about 5 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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