MEDICARE: JEFFREY BLANKENSHIP MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	PT37510	CA

General Provider Information

NPI Number	:	1487950481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY BLANKENSHIP MPT

Provider Business Mailing Address
First Line	:	1421 KAREN DR
Second Line	:
City	:	BENICIA
State	:	CA
Zip	:	94510-2633
Country	:	US
Telephone Number	:	559-786-5372
Fax Number	:

Provider Business Practice Location Address
First Line	:	2970 HILLTOP MALL RD STE 203
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-1949
Country	:	US
Telephone Number	:	510-222-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2011
Last Update Date	:	06/11/2023

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Directions to “ JEFFREY BLANKENSHIP MPT” Practice Location

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