Organization
ICI 24 7 PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L BLOOM M.D., (PRESIDENT)
(978) 552-2732
Entity
Organization
Contact information
Practice address
5820 OBERLIN DR, SUITE 205, SAN DIEGO, CA 92121-3742
(858) 453-9729
Mailing address
100 BAYVIEW CIR, SUITE 400, NEWPORT BEACH, CA 92660-2983
(949) 242-5300
(949) 242-5397
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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