SearchCalifornia237700000X

Kenneth Blake, H.I.S

NPI 1013933589 · on the registry since 2006 · sole proprietor

Practice

Address
39000 Bob Hope Drive Probst 315
Rancho Mirage, CA 92270
Phone
(760) 625-6616
Fax
(442) 666-3766

Registry record

Primary taxonomy
237700000X
237700000X
Also registered as
111N00000X
111N00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-06-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California