Blake, Kenneth

Blake, Kenneth is an sole proprietor health care provider with primary practice located at 39000 Bob Hope Drive Probst 315 , Rancho Mirage CA 92270-3221. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Speech, Language and Hearing Service Providers / Hearing Instrument Specialist. Speech, Language and Hearing Service Providers / Hearing Instrument Specialist is his primary health care specialty. Blake, Kenneth can be contacted via phone (760) 625-6616.

Contact Information

Primary practice address
39000 Bob Hope Drive Probst 315 Rancho Mirage CA 92270-3221
Phone: (760) 625-6616
Fax: (442) 666-3766
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X DC172371 California
Chiropractic Providers / Chiropractor 111N00000X DC17237 California
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X HA7407 California

Profile Details

NPI number 1013933589
LBN Legal business name Blake, Kenneth
Credentials H.I.S.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2006
Last updated Jun 4th, 2019 - about 6 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 1013933589 NPPES
California Other DC172371 INSURANCE COMPANIES

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