Individual provider · Type 1 NPI

Keron Rohan Blackford

Student in an Organized Health Care Education/Training Program · San Diego, CA

NPI number 1003794819 Active

Practice location

1465 30th St Ste K
San Diego, CA 92154-3497

Call (619) 428-1000 Map

Fax (619) 428-1091

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1003794819

Keron Rohan Blackford's National Provider Identifier is 1003794819, issued on Aug 21, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in San Diego, CA. The record was last updated on Aug 21, 2025.