DR. BLAKE ANDREW WYLIE (NPI# 1922314145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922314145 |
| Entity Type | Individual |
| Full Name | DR. BLAKE ANDREW WYLIE |
| Credential | D.O. |
| Practice Address |
2721 Washington Street Julian CA 92036 |
| Practice Telephone | 6193982405 |
| Practice Fax Number | 6193982412 |
| Mailing Telephone | 7607651223 |
| Mailing Fax Number | 7607651278 |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2012-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 20A11088 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2721 WASHINGTON STREET |
| City | JULIAN |
| State | CA |
| Zip Code | 92036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639510985 | Vista Hill Smartcare | Community/Behavioral Health | 2721 Washington Street, Julian, CA 92036 | 2013-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407492549 | Joshua Mason Brown | Psychologist | 1704 Cape Horn Ln., Julian, CA 92036 | 2019-11-25 |
| 1720587561 | Cathleen Erin Shaffer | Nurse Practitioner | 2712 Washington St, Julian, CA 92036 | 2018-02-07 |
| 1497019103 | Julian Union School District | Local Education Agency (LEA) | 1704 Cape Horn, Julian, CA 92036 | 2012-06-27 |
| 1881929875 | Jennifer Suzanne Roberts | Marriage & Family Therapist | 2907 Washington Street, Ste B, Julian, CA 92036 | 2009-10-08 |
| 1063660355 | Brian James Denny | Chiropractor | 1455 Hollow Glen Road, Julian, CA 92036 | 2008-08-29 |
| 1700946969 | Borrego Community Health Foundation | Family Medicine | 2721 Washington St, Julian, CA 92036 | 2006-12-11 |
| 1144210147 | Julian Cuyamaca Fire Protection | Ambulance | 2645 Farmers Rd, Julian, CA 92036 | 2005-10-21 |
| 1053411900 | James Colbert | Counselor | 3275 Dolores Dr., Julian, CA 92036-0459 | 2006-09-22 |
| 1205046935 | Robert Ian Goldenberg | Dentist | 2602 Washington Street, Julian, CA 92036-0696 | 2007-05-23 |
| 1992103808 | Regina Victoria Montalvo-aguilera | Acupuncturist | 2130 Wynola Road, Julian, CA 92036-1958 | 2014-12-09 |
| Find all providers in zip 92036 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700946969 | Borrego Community Health Foundation | Family Medicine | 2721 Washington St, Julian, CA 92036 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407711 | Prohealth Partners A Medical Group | Family Medicine | 3700 Katella Ave Ste D, Los Alamitos, CA 90720-6410 | 2020-11-06 |
| 1831790112 | Universal Healthcare Services, Inc. | Family Medicine | 6025 Niles St, Bakersfield, CA 93306-4696 | 2020-11-04 |
| 1568063923 | Claude Kathy Marquis | Family Medicine | 400 S June St, Los Angeles, CA 90020-4812 | 2020-11-03 |
| 1417558842 | San Judas Tadeo Medical Group, Inc. | Family Medicine | 1000 S La Brea Ave Ste 2, Inglewood, CA 90301-3869 | 2020-11-03 |
| 1174123038 | Socal Medical Center., Inc. | Family Medicine | 1350 E Los Angeles Ave Ste 204, Simi Valley, CA 93065-2860 | 2020-10-29 |
| 1205435864 | Montana Affinity LLC | Family Medicine | 820 N Mountain Ave Ste 103, Upland, CA 91786-4163 | 2020-10-23 |
| 1861091126 | Silvia Diego Md Inc A Professional Medical Corp | Family Medicine | 1317 Oakdale Rd Ste 100, Modesto, CA 95355-3362 | 2020-10-19 |
| 1245838879 | Lalaine Talagtag Smith | Family Medicine | 919 Mariner Dr Apt C, Mountain View, CA 94043-3372 | 2020-10-15 |
| 1417554023 | Hameed A. Khan, M.d., Inc. | Family Medicine | 3655 Lomita Blvd Ste 421, Torrance, CA 90505-1934 | 2020-10-06 |
| 1073120085 | Garrison Family Medical Group Inc | Family Medicine | 41210 11th St W Ste C, Palmdale, CA 93551-1447 | 2020-09-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.