Melissa Beth Blake, PA-C
Physician Assistant in Carlsbad, CA. Individual provider (NPI-1).
NPI number1740655653
StatusActive
Last updated in NPPESJul 6, 2018
Details
- NPI
- 1740655653
- Entity type
- Individual (NPI-1)
- Name
- Ms. Melissa Beth Blake
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 2, 2015
- Last updated
- Jul 6, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 53050 | CA | Yes |
Practice location
2176 Salk AveCarlsbad, CA 92008
Phone 760-901-5100 · Fax 760-827-7425
Mailing address
10790 Rancho Bernardo RdSan Diego, CA 92127-5705
Phone 760-901-5100
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