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Organization
STUART L BLOOM DO A PROFFESSIONAL CORPORATION
Active
Organization
STUART L BLOOM DO A PROFFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART BLOOM D.O. (SOLE OWNER)
(818) 888-7815
Entity
Organization
Contact information
Practice address
2601 W ALAMEDA AVE, STE# 314, BURBANK, CA 91505-4800
(818) 842-9728
(818) 715-1722
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20A3367
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
20A3367
CA
Other
Enumeration date
03/27/2006
Last updated
06/23/2009
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