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

Patrick W Blake, MD

Individual provider Dermatology Physician · NPI 1871817312

Patrick W Blake, MD is a Dermatology in San Diego, California. Graduated from Clvlnd Clinic Lerner College of Med of Case Wstn Rsv University in 2010, 16 years ago. Practices with Medderm Corporation, a 6-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Texas.

Years since qualifying
16
Trained at
Clvlnd Clinic Lerner College of Med of Case Wstn Rsv University
Licensed in
CA, TX
In the registry since
2010
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

501 Washington St Ste 502
San Diego, CA 92103-2231
Phone: (619) 542-0013
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence A130951 (CA)
Dermatology Physician Taxonomy 207N00000X · Licence P3510 (TX)

Record details

NPI number1871817312
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 25, 2010
Last updated in NPPESJanuary 18, 2017
Mailing address501 Washington St, Suite 502, San Diego, CA 92103-2231

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolCLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated 2010 (16 years in practice)
Group practice Medderm Corporation — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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