Healthcare Provider Details

I. General information

NPI: 1942825112
Provider Name (Legal Business Name): BLASKO MEDICAL CONSULTANTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12523 LIMONITE AVE SUITE 440 #144
EASTVALE CA
91752
US

IV. Provider business mailing address

11576 PETUNIA CT
JURUPA VALLEY CA
91752-5013
US

V. Phone/Fax

Practice location:
  • Phone: 805-217-0317
  • Fax: 262-394-0836
Mailing address:
  • Phone: 949-300-9720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BARBARA BLASKO
Title or Position: CEO
Credential: MD
Phone: 949-300-9720