Individual
DR. MATTHEW LEE BLOOM
Active
Individual
DR. MATTHEW LEE BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
20A16383
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A16383
STATE LICENSE
CA
Enumeration date
05/04/2015
Last updated
12/16/2022
Update your record
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