Individual
GARY M BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2320 BATH ST, SUITE 208, SANTA BARBARA, CA 93105-4339
(805) 682-7984
(805) 569-2964
Mailing address
PO BOX 15778, IRVINE, CA 92623-5778
(949) 263-8620
(949) 263-0473
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G58816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G588160
BLUE SHIELD OF CA
CA
05
—
00G588160
—
CA
01
—
300057286
RR MC
CA
Enumeration date
05/17/2006
Last updated
04/09/2014
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