Provider Demographics
NPI:1184303422
Name:BLINDER, JOSEPH NATHAN
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:NATHAN
Last Name:BLINDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N LAKE MERCED HLS
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-2907
Mailing Address - Country:US
Mailing Address - Phone:415-987-8966
Mailing Address - Fax:
Practice Address - Street 1:221 N LAKE MERCED HLS
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-2907
Practice Address - Country:US
Practice Address - Phone:415-987-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95294367163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse