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General NPI Number Information
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NPI Number | 1942825112
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Entity Type | Organization
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Legal Business Name | BLASKO MEDICAL CONSULTANTS INC.
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Dates
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Enumeration Date | 06/12/2020
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Last Update Date | 06/12/2020
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Provider Practice Location Address
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Address Line | 11576 PETUNIA CT
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City | MIRA LOMA
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State | CA
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Zip | 91752-5013
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Country | US
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Telephone | 949-300-9720
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Fax |
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Provider Business Mailing Address
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Address Line | 11576 PETUNIA CT
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City | JURUPA VALLEY
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State | CA
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Zip | 91752-5013
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Country | US
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Telephone | 949-300-9720
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BARBARA BLASKO
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Credential | MD
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Telephone | 949-300-9720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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