Blake Watts

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

18112 Issued in CA

Legal business name

BLAKE WATTS

Practice address

4123 Crest Dr
Manhattan Beach, CA 90266-3068

Phone

(858) 922-3145

NPI assigned

Mar 1, 2012

Last updated

Mar 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Blake Watts, CPNP, RNFA

Title

Assistant Surgeon

Phone

(858) 922-3145

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1740554120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 CREST DR",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663068",
            "telephone_number": "858-922-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 CREST DR",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663068",
            "telephone_number": "858-922-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE WATTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "ASSISTANT SURGEON",
        "authorized_official_telephone_number": "858-922-3145",
        "authorized_official_credential": "CPNP, RNFA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "18112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua J. Berger, MD,PHD
• Joy Bhat, M.D.
• Diego Andres Bignone
• Birznieks Chiropractic, Inc.
• David Birznieks
• Summer Lynn Blake, D.D.S.
• Yifat Block, PSY.D., L.C.S.W.
• Peter James Bloomfield, M.D.
• Body in Balance Health Center and Spa
• Viviana Bonansea

• Ambulatory Surgical Clinic/Center in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.