Marshall Edward Blesofsky, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 11155 Issued in CA

Practice address

3917 Linden Ave
Long Beach, CA 90807-2714

Phone

(562) 760-8823

Fax

(562) 252-8242

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Earlwood, LLC

  • Skilled Nursing Facility
  • Torrance, CA
  • NPI 1720153620
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1689718579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072714",
            "telephone_number": "562-760-8823",
            "fax_number": "562-252-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072714",
            "telephone_number": "562-760-8823",
            "fax_number": "562-252-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLESOFSKY",
        "first_name": "MARSHALL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 11155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICEN",
            "identifier": "PA 11155",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Blasco, L.C.S.W.
• Gloria J. Blatt, CNS
• Aelaine M. Blaza
• Mieka K Bledsoe, MS, LMFT
• Yolanda Bledsoe
• Blessed Life Assisted Living Facility
• Blessingshealthcare, LLC
• Jeannie C. Blilie, RNP
• Jonathan B. Blitzer, MD
• Bloch Chiropractic Wellness and Sports Medicine PC

• All providers in Long Beach, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.