Blodgett, Kevin

Blodgett, Kevin is an individual health care provider with primary practice located at 1850 Sullivan Ave Suite 330, Daly City CA 94015-2221. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Blodgett, Kevin can be contacted via phone (650) 756-5630.

Contact Information

Primary practice address
1850 Sullivan Ave Suite 330 Daly City CA 94015-2221
Phone: (650) 756-5630
Fax: (650) 756-0136
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA19212 California

Profile Details

NPI number 1619173010
LBN Legal business name Blodgett, Kevin
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2007
Last updated Nov 29th, 2021 - about 3 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 1619173010 NPPES
California Other P00615831 MEDICARE RR
California Other PA19212 MEDICARE RR

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