Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Blake Andrew Wylie, DO

Individual provider Family Medicine Physician · NPI 1922314145

Dr. Blake Andrew Wylie, DO is a Family Practice in Laguna Hills, California. Qualified in 2008, 18 years ago. Practices with Centro De Salud De La Comunidad De San Ysidro, Inc, a 291-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2010
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

23181 Verdugo Dr Ste 103A
Laguna Hills, CA 92653-1313
Phone: (949) 366-1053
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 20A11088 (CA)

Record details

NPI number1922314145
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedAugust 25, 2010
Last updated in NPPESMarch 31, 2021
Certification dateMarch 31, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Centro De Salud De La Comunidad De San Ysidro,Inc. — 291 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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