Provider Demographics
NPI:1336156769
Name:BLAND, HOWARD KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:KENNETH
Last Name:BLAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2302
Mailing Address - Country:US
Mailing Address - Phone:949-923-3277
Mailing Address - Fax:855-812-5865
Practice Address - Street 1:1198 PACIFIC COAST HWY STE I
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6248
Practice Address - Country:US
Practice Address - Phone:562-799-7071
Practice Address - Fax:562-594-5627
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2021-09-27
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Provider Licenses
StateLicense IDTaxonomies
CAA61709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01015538OtherRR MEDICARE
CAP01015538OtherRR MEDICARE