Richard Gary Blake, R.D.O.

Primary specialty

OpticianTaxonomy code 156FX1800X

License

D006638 Issued in CA

Practice address

21835 Ventura Blvd
Woodland Hills, CA 91364-1838

Phone

(818) 883-9567

Fax

(818) 883-5261

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174650071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 DEEP WOOD DR",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624215",
            "telephone_number": "805-495-4046",
            "fax_number": "808-883-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21835 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641838",
            "telephone_number": "818-883-9567",
            "fax_number": "818-883-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "RICHARD",
        "middle_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "R.D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "D006638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan A Blackledge
• Kristen R Blackman, PA-C
• Claudia Lynn Blackwood
• Richard Linn Blada, PA-C
• Martin W Blain, DPM
• Tariq Blake
• Monica Blancarte
• Rod A. Blau, MD
• Tracey Ann Bleahu, D.C.
• Allan H. Bledstein, MD

• Optician in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Optician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.