Provider Demographics
NPI:1154626505
Name:BLESSING, DEVIN (DPT)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:BLESSING
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11825 MAJOR ST
Mailing Address - Street 2:PENTHOUSE SUITE
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6356
Mailing Address - Country:US
Mailing Address - Phone:310-915-6100
Mailing Address - Fax:
Practice Address - Street 1:11825 MAJOR ST
Practice Address - Street 2:PENTHOUSE SUITE
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6356
Practice Address - Country:US
Practice Address - Phone:310-915-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033423-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ4WFH1Medicare PIN