Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Will Richard Blackmon III, PA-C

Individual provider Physician Assistant · NPI 1073925160

Mr. Will Richard Blackmon III, PA-C is a Physician Assistant in Emeryville, California. Licensed in California. Registered with an NPI since 2014.

Licensed in
CA
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2100 Powell St Ste 920
Emeryville, CA 94608-1826
Phone: (925) 939-5800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 51619 (CA)

Record details

NPI number1073925160
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 23, 2014
Last updated in NPPESMay 13, 2016

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