MEDICARE: GEORGE ARTHUR BLAIR II MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	C41463	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588678973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE ARTHUR BLAIR II MD

Provider Business Mailing Address
First Line	:	PO BOX 34490
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-0490
Country	:	US
Telephone Number	:	310-490-2867
Fax Number	:	310-204-1253

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE
Second Line	:	STE 215
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5385
Country	:	US
Telephone Number	:	310-490-2867
Fax Number	:	310-204-1253

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	09/21/2023

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