Healthcare Provider Details

I. General information

NPI: 1003844051
Provider Name (Legal Business Name): DAN BLECHMAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 BALBOA BLVD #111
ENCINO CA
91316-1502
US

IV. Provider business mailing address

PO BOX 7001
TARZANA CA
91357-7001
US

V. Phone/Fax

Practice location:
  • Phone: 818-784-8975
  • Fax: 818-784-7467
Mailing address:
  • Phone: 818-888-7815
  • Fax: 818-715-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DAN BLECHMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 818-784-8975