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Dr. Blake Tarleton Henderson, MD
Student in an Organized Health Care Education/Training Program in San Francisco, California
NPI 1992064893

Blake Tarleton Henderson is a Student in an Organized Health Care Education/Training Program based in San Francisco, CA. Blake Tarleton Henderson practices in San Francisco, CA and has the professional credentials of MD. The NPI Number for Blake Tarleton Henderson is 1992064893 and holds a License No. (California).

The current practice location address for Blake Tarleton Henderson is 2425 Geary Blvd # M160, San Francisco, CA and can be reached out via phone at 916-521-6062.

Location: 2425 Geary Blvd # M160, San Francisco, CA, 94115-3358
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992064893
Provider Name
Blake Tarleton Henderson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2425 Geary Blvd # M160, San Francisco, CA, 94115-3358
Phone Number
916-521-6062
Fax Number
Provider Enumeration Date
05/11/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2425 Geary Blvd # M160
City
San Francisco
State
California
Zip
94115-3358
Phone Number
916-521-6062
Fax Number
person
Provider Business Mailing Address Details
Address
2425 Geary Blvd # M160
City
San Francisco
State
California
Zip
94115-3358
Phone Number
916-521-6062
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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