Healthcare Provider Details

I. General information

NPI: 1376750224
Provider Name (Legal Business Name): BLAIR S. KRANSON M.D., A PROFESSIONAL MEDICAL COPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 WOODLAKE AVE STE 395
WEST HILLS CA
91307-1496
US

IV. Provider business mailing address

7320 WOODLAKE AVE STE 395
WEST HILLS CA
91307-1468
US

V. Phone/Fax

Practice location:
  • Phone: 818-347-0681
  • Fax: 818-347-0955
Mailing address:
  • Phone: 818-347-0681
  • Fax: 818-347-0955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG40294
License Number StateCA

VIII. Authorized Official

Name: BLAIR S KRANSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-349-0681