Individual
DR. JEFFREY HOWARD BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
20311 SW ACACIA ST, SUITE 100, NEWPORT BEACH, CA 92660-1733
(949) 263-1242
(949) 263-1280
Mailing address
7435 PALOMA DR, HUNTINGTON BEACH, CA 92648-6833
(714) 420-6620
(949) 263-1280
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
20A6397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A6397
STATE LICENSE NUMBER
CA
Enumeration date
07/27/2005
Last updated
07/08/2007
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