Individual
ERNEST BLOOM
Active
Individual
ERNEST BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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