Bleu Physical Therapy and Performance PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

38287 Issued in CA

Legal business name

BLEU PHYSICAL THERAPY AND PERFORMANCE PC

Practice address

1819 W Valley Blvd # B
Alhambra, CA 91803-2344

Phone

(323) 428-8011

NPI assigned

Oct 24, 2014

Last updated

Oct 24, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jackie Lau, D.P.T.NPI 1700288578

Title

Owner

Phone

(323) 428-8011

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jackie Lau, PT, DPT

  • Physical Therapist
  • South Pasadena, CA
  • NPI 1700288578
  Medicare reassignment Authorized official
• Sinmen Tse, PTA

  • Physical Therapy Assistant
  • Duarte, CA
  • NPI 1447880422
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1609271279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 CAMINO LINDO",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304131",
            "telephone_number": "323-428-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 W VALLEY BLVD # B",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918032344",
            "telephone_number": "323-428-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLEU PHYSICAL THERAPY AND PERFORMANCE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-428-8011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Alhambra, CA
• Providers in Alhambra, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.