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Individual

EVAN D BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1001 POTRERO AVE, SUITE 1E21, SAN FRANCISCO, CA 94110-3518
(415) 206-8111
Mailing address
230 OAK ST, APT 32, SAN FRANCISCO, CA 94102-5841
(415) 487-5040

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
235804
MA
207P00000X
Emergency Medicine Physician
A108485
CA

Other

Enumeration date
06/16/2008
Last updated
03/17/2010
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