Alexander, Blake Daniel

Alexander, Blake Daniel is an individual health care provider with primary practice located at 1101 Standiford Ave Suite A-3, Modesto CA 95350-0982. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Alexander, Blake Daniel can be contacted via phone (209) 578-5072.

Contact Information

Primary practice address
1101 Standiford Ave Suite A-3 Modesto CA 95350-0982
Phone: (209) 578-5072
Fax: (209) 578-5292
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X C52849 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X C52849 California

Profile Details

NPI number 1033132170
LBN Legal business name Alexander, Blake Daniel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Sep 3rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033132170 NPPES
California Other ZZZ48224Z MEDICARE IDENTIFICATION #

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