Individual
DR. MATTHEW LEE BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1280 S VICTORIA AVENUE, SUITE # 250, VENTURA, CA 93003-9300
(805) 351-0745
(805) 288-6744
Mailing address
1280 S VICTORIA AVENUE, SUITE #250, VENTURA, CA 93003-7844
(805) 351-0745
(805) 830-1177
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
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