IndividualActive
Andre Blake, P.A.
NPI 1588655682 · Surgical Physician Assistant · Redlands, CA
Provider details
- NPI number
- 1588655682
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- P.A.
- Sex
- Male
- Sole proprietor
- No
- License
- PA16708 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2 W Fern Ave
Redlands, CA 92373-5916
Phone: (909) 793-3311
Fax: (909) 335-4190
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 10069
San Bernardino, CA 92423-0069
Registry dates
- Enumerated
- 2005-10-31
- Last updated
- 2020-02-03
- Certified
- 2020-02-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.