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

Mr. Andre Anthony Blake, PA

Individual provider Surgical Physician Assistant · NPI 1588655682

Mr. Andre Anthony Blake, PA is a Surgical Physician Assistant in Redlands, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

2 W Fern Ave
Redlands, CA 92373-5916
Phone: (909) 793-3311
Fax: (909) 335-4190
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA16708 (CA)

Record details

NPI number1588655682
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 31, 2005
Last updated in NPPESFebruary 3, 2020
Certification dateFebruary 3, 2020
Mailing addressPo Box 10069, San Bernardino, CA 92423-0069

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