Active NPI
Daniel Blackburn
- Other Specialist/Technologist
- Redwood City, CA
National Provider Identifier
1689537920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- 1605
- Practice address
- 170 Alameda de Las Pulgas
Redwood City, CA 94062-2751 - Phone
- (650) 367-5636
- NPI assigned
- Dec 4, 2025
- Last updated
- Dec 4, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | 1605 | CA | Primary |
Addresses
Primary practice location
170 Alameda de Las Pulgas
Redwood City, CA 94062-2751
Mailing address
3898 Monterey Dr
Grove City, OH 43123-2842
Phone (614) 832-5308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1605 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764806400000",
"number": "1689537920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3898 MONTEREY DR",
"city": "GROVE CITY",
"state": "OH",
"postal_code": "431232842",
"telephone_number": "614-832-5308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 ALAMEDA DE LAS PULGAS",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940622751",
"telephone_number": "650-367-5636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-12-04",
"last_updated": "2025-12-04",
"certification_date": "2025-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "CA",
"license": "1605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.