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General NPI Number Information
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NPI Number | 1497814115
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Entity Type | Individual
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Provider Name | STEVEN MICHAEL BLIZZARD PA
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 7777 SUNRISE BLVD SUITE 2500
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-2300
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Country | US
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Telephone | 916-722-2227
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Fax | 877-860-5422
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Provider Business Mailing Address
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Address Line | 625 FAIR OAKS AVE STE 270
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-5801
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Country | US
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Telephone | 626-346-2455
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Fax | 626-639-3005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA11136
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License Number State | CA
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