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Gerald Alan Blake, MD
Specialist in Calimesa, California
NPI 1457392938

Gerald Alan Blake is a Specialist based in Beaumont, CA. Gerald Alan Blake practices in Calimesa, CA and has the professional credentials of MD. The NPI Number for Gerald Alan Blake is 1457392938 and holds a License No. A32432 (California).

The current practice location address for Gerald Alan Blake is 1096 Calimesa Blvd Ste D, Calimesa, CA and can be reached out via phone at 909-722-1240 and via fax at 909-446-8800.

Location: 1096 Calimesa Blvd Ste D, Calimesa, CA, 92223-8579
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457392938
Provider Name
Gerald Alan Blake
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1096 Calimesa Blvd Ste D, Calimesa, CA, 92223-8579
Phone Number
909-722-1240
Fax Number
909-446-8800
Provider Enumeration Date
06/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A324320 05 CA
institution
Provider Business Practice Location Address Details
Address
1096 Calimesa Blvd Ste D
City
Calimesa
State
California
Zip
92320-1559
Phone Number
909-722-1240
Fax Number
909-446-8800
person
Provider Business Mailing Address Details
Address
1096 Calimesa Blvd Ste D
City
Calimesa
State
California
Zip
92320-1559
Phone Number
909-722-1240
Fax Number
909-446-8800
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
A32432 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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