Provider Demographics
NPI:1336156769
Name:BLAND, HOWARD KENNETH (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:KENNETH
Last Name:BLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23595 MOULTON PKWY STE E
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1939
Practice Address - Country:US
Practice Address - Phone:949-218-0853
Practice Address - Fax:949-218-0856
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA61709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01015538OtherRR MEDICARE
CAP01015538OtherRR MEDICARE