MR. Michael Blackwell, PA-C

NPI #1629054705 in Atascadero, California

Provider Information

NPI Number: 1629054705
Entity Type: Individual
Name: MR. Michael Blackwell, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Dec 20, 2005
Last Updated: Apr 23, 2009

Practice Location

Address: 9700 EL CAMINO REAL
Address 2: SUITE 100
City: Atascadero
State: California
ZIP Code: 93422
Phone: (805) 461-9000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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