Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fd Blade Branham, PT

Individual provider Physical Therapist · NPI 1114902392

Fd Blade Branham, PT is a Physical Therapist in Private Practice in Palm Desert, California. Qualified in 1988, 38 years ago. Practices with Performance Health Medical Group, Inc, a 6-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
38
Licensed in
CA
In the registry since
2005
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

73345 Highway 111 Ste 103
Palm Desert, CA 92260
Phone: (760) 340-1812
Fax: (760) 340-1852
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT15311 (CA)

Record details

NPI number1114902392
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedDecember 12, 2005
Last updated in NPPESJuly 13, 2026
Mailing address5962 La Place Court, Suite 170, Carlsbad, CA 92008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice Performance Health Medical Group, Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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