Individual
DR. JUSTIN GLAVIS-BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-7237
Mailing address
200 S MANCHESTER AVE STE 300, ORANGE, CA 92868-3219
(714) 456-2986
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
A154223
CA
2085R0202X
Diagnostic Radiology Physician
345511
NY
2085R0202X
Diagnostic Radiology Physician
A154223
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2016
Last updated
07/14/2026
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