Provider Demographics
NPI:1942825112
Name:BLASKO MEDICAL CONSULTANTS INC.
Entity Type:Organization
Organization Name:BLASKO MEDICAL CONSULTANTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLASKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-300-9720
Mailing Address - Street 1:11576 PETUNIA CT
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91752-5013
Mailing Address - Country:US
Mailing Address - Phone:949-300-9720
Mailing Address - Fax:
Practice Address - Street 1:11576 PETUNIA CT
Practice Address - Street 2:
Practice Address - City:MIRA LOMA
Practice Address - State:CA
Practice Address - Zip Code:91752-5013
Practice Address - Country:US
Practice Address - Phone:949-300-9720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty