Healthcare Provider Details

I. General information

NPI: 1265079768
Provider Name (Legal Business Name): JOHN PAUL BLIAMPTIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 HEALTH SCIENCES DR # 829
LA JOLLA CA
92093-0845
US

IV. Provider business mailing address

3855 HEALTH SCIENCES DR # 829
LA JOLLA CA
92093-0845
US

V. Phone/Fax

Practice location:
  • Phone: 858-657-5281
  • Fax:
Mailing address:
  • Phone: 858-657-5281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA189236
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: