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1588655682
ANDRE ANTHONY BLAKE
REDLANDS, CA
NPI
1588655682
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: CA PA16708)
Enumeration Date
2005-10-31
Last Update Date
2020-02-03
Business Address
Mr. ANDRE ANTHONY BLAKE P.A.
2 W FERN AVE
REDLANDS, CA 92373-5916
Phone number: 909-793-3311
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Mailing Address
Mr. ANDRE ANTHONY BLAKE P.A.
PO BOX 10069
SAN BERNARDINO, CA 92423-0069
Phone number:
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