Michael P Blasko, PA
Physician Assistant in Newport Beach, CA. Individual provider (NPI-1).
NPI number1124100300
StatusActive
Last updated in NPPESDec 1, 2021
Details
- NPI
- 1124100300
- Entity type
- Individual (NPI-1)
- Name
- Michael P Blasko
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 19, 2006
- Last updated
- Dec 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 00000PA17281 | CA | Yes |
Practice location
4631 Teller Ave Ste 100Newport Beach, CA 92660-8105
Phone 949-335-7500 · Fax 949-387-1206
Mailing address
4631 Teller Ave Ste 100Newport Beach, CA 92660-8105
Phone 949-335-7500 · Fax 949-387-1206
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