person
Norma Lynn Blackwater, MD
General Practice Physician in Los Angeles, California
NPI 1457476038

Norma Lynn Blackwater is a General Practice Physician based in Los Angeles, CA. Norma Lynn Blackwater practices in Los Angeles, CA and has the professional credentials of MD. The NPI Number for Norma Lynn Blackwater is 1457476038 and holds a License No. G83912 (California).

The current practice location address for Norma Lynn Blackwater is 1125 W 6Th St, Los Angeles, CA and can be reached out via phone at 213-202-3970 and via fax at 213-975-9257.

Location: 1125 W 6Th St, Los Angeles, CA, 90017-1833
person
Provider Profile Details
NPI Number
1457476038
Provider Name
Norma Lynn Blackwater
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
1125 W 6Th St, Los Angeles, CA, 90017-1833
Phone Number
213-202-3970
Fax Number
213-975-9257
Provider Enumeration Date
03/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00G839120 05 CA
institution
Provider Business Practice Location Address Details
Address
1125 W 6Th St
City
State
Zip
90017-1833
Phone Number
213-202-3970
Fax Number
213-975-9257
person
Provider Business Mailing Address Details
Address
1125 W 6Th St
City
State
Zip
90017-1833
Phone Number
213-202-3970
Fax Number
213-975-9257
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
G83912 (California)
Definition
Definition to come...
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