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1881006674
RANDY BLAKE
LOS ANGELES, CA
NPI
1881006674
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA 563948)
Enumeration Date
2014-05-28
Last Update Date
2021-03-23
Business Address
RANDY BLAKE RN
550 S VERMONT AVE FL 10
LOS ANGELES, CA 90020-1912
Phone number: 310-217-7312
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Mailing Address
RANDY BLAKE RN
735 N NEIL ST
WEST COVINA, CA 91791-1120
Phone number: 626-780-4170
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