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Andre V. Blaylock

Debarred entity

Andre V. Blaylock is a person of interest. They have not been found on international sanctions lists.

Type	Person				[sources]
Name	Andre V. Blaylock · Andre Vergene Blaylock				[sources]
Birth date	not available				[sources]
Nationality	not available				[sources]
Country	United States				[sources]
First name	Andre				[sources]
ID Number	`G-51438`				[sources]
Last name	Blaylock				[sources]
Middle name	V.				[sources]
NPI	`1235287160`				[sources]
Registration number	`00G514380` · `G51438`				[sources]
Sector	Physician				[sources]
Address	9985 Sierra, Fontana, CA, 92335				[sources]
Last change	2025-05-21	Last processed	2025-11-17	First seen	2024-11-07

Sanctions
Country	Authority	Program	Start date	End date
United States	California Department of Human services		2014-07-17	-

List of providers excluded from participating in the Delaware Medicaid program.

United States · DHSS

Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.

United States · DHCS

Source data IDs: us-medde-dca410d9ed5ad9b40a10d065dbf31124589592cc · us-medca-91a4f8827610ef23b91e8bca5ce72a5eafb2e3ee

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