Provider Demographics
NPI:1215268438
Name:BLESSED ORTHOPEDIC PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:BLESSED ORTHOPEDIC PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:310-926-6401
Mailing Address - Street 1:PO BOX 341194
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-9194
Mailing Address - Country:US
Mailing Address - Phone:310-926-6401
Mailing Address - Fax:
Practice Address - Street 1:3916 SEPULVEDA BLVD STE 208
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4651
Practice Address - Country:US
Practice Address - Phone:310-926-6401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35518261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy