Provider Demographics
NPI:1982879961
Name:BLAND, CHERYL KING (NP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:KING
Last Name:BLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:23548 CALABASAS ROAD #105
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1341
Mailing Address - Country:US
Mailing Address - Phone:818-222-0025
Mailing Address - Fax:818-222-0035
Practice Address - Street 1:23548 CALABASAS ROAD #105
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1341
Practice Address - Country:US
Practice Address - Phone:818-222-0025
Practice Address - Fax:818-222-0035
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024164388363LF0000X
CA11248363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily