Individual
AMANDA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3124 INTERNATIONAL BLVD, SUITE 200, OAKLAND, CA 94601-2902
(510) 535-4400
Mailing address
3124 INTERNATIONAL BLVD, SUITE 200, OAKLAND, CA 94601-2902
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12532
CA
Other
Enumeration date
07/09/2006
Last updated
07/21/2022
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