MR. MATTHEW ALEXANDER BLAKE IDC
NPI 1699278952
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Q: What is Matthew Blake's NPI number?

The NPI number for Matthew Blake is 1699278952. It was assigned to this individual provider in the NPPES registry on March 13, 2018.

Q: What is Matthew Blake's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Blake was last updated on March 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 13, 2018

1336 BRUNNER ST APT H, SAN DIEGO, CA 92110(931) 865-6165 Get Directions Write a Review

NPPES record last updated: March 13, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Matthew Alexander Blake Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MATTHEW ALEXANDER BLAKE IDC (NPI 1699278952) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1699278952

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMR. MATTHEW ALEXANDER BLAKECredential: IDC

Location Address1336 BRUNNER ST APT HSan Diego, CA 92110-1690

Mailing Address1336 Brunner St Apt HSan Diego, CA 92110-1690 · (931) 865-6165

Phone(931) 865-6165

Sole ProprietorNo

Enumeration DateMarch 13, 2018

✔ NPI 1699278952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

1336 BRUNNER ST APT H, San Diego, CA 92110

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Blake's NPI number?

The NPI number for Matthew Blake is 1699278952. It was assigned to this individual provider in the NPPES registry on March 13, 2018.

Where is Matthew Blake located?

Matthew Blake practices at 1336 Brunner St Apt H, San Diego, CA 92110. The listed phone number is (931) 865-6165.

What is Matthew Blake's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Matthew Blake was last updated on March 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.