Gerald Theadore Blackmon III
NPI #1750691994 in Beaumont, California
Provider Information
- NPI Number
- 1750691994
- Entity Type
- Individual
- Name
- Gerald Theadore Blackmon III
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Non-emergency Medical Transport (VAN)
- Enumeration Date
- Oct 20, 2010
- Last Updated
- Oct 20, 2010
Practice Location
- Address
- 1665 S MONTE VERDE DR
- City
- Beaumont
- State
- California
- ZIP Code
- 92223-8589
- Phone
- (951) 663-6995
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-emergency Medical Transport (VAN) |
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