Provider Demographics
NPI:1518339779
Name:BLOCK, BELINDA (PT)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:BLOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 LAKES DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2924
Mailing Address - Country:US
Mailing Address - Phone:626-918-6655
Mailing Address - Fax:626-918-6655
Practice Address - Street 1:935 WEST FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4700
Practice Address - Country:US
Practice Address - Phone:909-621-3425
Practice Address - Fax:909-621-3427
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT151882251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT15188OtherCALIFORNIA LICENSE