Individual
ERNEST BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 S SHORE CTR W, 103A, ALAMEDA, CA 94501-5762
(510) 227-7028
(510) 274-7119
Mailing address
501 S SHORE CTR W, 103A, ALAMEDA, CA 94501-5762
(510) 227-7028
(510) 274-7119
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
G56359
CA
207ND0101X
MOHS-Micrographic Surgery Physician
G56359
CA
207ND0900X
Dermatopathology Physician
Primary
G56359
CA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
G56359
CA
207NP0225X
Pediatric Dermatology Physician
G56359
CA
207NS0135X
Procedural Dermatology Physician
G56359
CA
Other
Enumeration date
09/13/2006
Last updated
01/31/2013
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