Provider Demographics
NPI:1548033491
Name:TRUEBLOOD, COURTNEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:TRUEBLOOD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10474 SANTA MONICA BLVD STE 435
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6932
Mailing Address - Country:US
Mailing Address - Phone:310-275-4137
Mailing Address - Fax:
Practice Address - Street 1:10474 SANTA MONICA BLVD STE 435
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6932
Practice Address - Country:US
Practice Address - Phone:310-275-4137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3051472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic