David Bliklen, M.D., P.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

17275 Issued in AZ

Legal business name

DAVID BLIKLEN, M.D., P.C.

Practice address

5757 W Thunderbird Rd
Suite E151
Glendale, AZ 85306-4685

Phone

(602) 843-3811

Fax

(602) 843-0044

NPI assigned

Dec 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Bliklen, M.D.

Title

President

Phone

(602) 843-3811

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1164605333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD",
            "address_2": "SUITE E 151",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064641",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD",
            "address_2": "SUITE E151",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064685",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID BLIKLEN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "BLIKLEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-843-3811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "17275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273441-01",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.