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Individual

DR. RICHARD BLOOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4105 COSTADO RD., PEBBLE BEACH, CA 93953-3004
(831) 626-3256
(831) 626-3268
Mailing address
4105 COSTADO RD., PEBBLE BEACH, CA 93953-3004
(831) 626-3256
(831) 626-3268

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
C27398
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C27398
NARCOTICS LICENSE # AB2042012
CA
Enumeration date
02/22/2012
Last updated
02/22/2012
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