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KENNETH JOEL BLOOM M.D.

Anatomic Pathology >> Pathology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1023399177

Individual Registrant:
 KENNETH JOEL BLOOM M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
31 COLUMBIA CPS ALISO VIEJO, CA 92656-1460 US
Tel: 949-425-5744  Fax: 949-425-5865

Contact information for business:
31 COLUMBIA CPS ALISO VIEJO, CA 92656-1460 US
Tel: 949-425-5744  Fax: 949-425-5865

Registration Information:
NPI: 1023399177
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207ZP0101XAllopathic & Osteopathic Physicians
Pathology
Anatomic Pathology
CAG86592

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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