Gary David Blake, M.D.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

G44807 Issued in CA

Practice address

8010 Frost St
Suite 402
San Diego, CA 92123-2778

Phone

(858) 565-8100

Fax

(858) 565-8200

NPI assigned

Nov 23, 2005

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1497738439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 FROST ST",
            "address_2": "SUITE 402",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232778",
            "telephone_number": "858-565-8100",
            "fax_number": "858-565-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 FROST ST",
            "address_2": "SUITE 402",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232778",
            "telephone_number": "858-565-8100",
            "fax_number": "858-565-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "GARY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": "G44807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Thompson MD Inc.
• Ashley Blake, PHARMD
• Brandon Blake
• Chrisjon Augustus Blake
• Denise M Blake, L.AC.
• Matthew Alexander Blake, IDC
• Nathan Blake, PPS
• Patricia Blake, L.AC
• Patrick W Blake, MD
• Robert E Blake

• Maternal & Fetal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Maternal & Fetal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.