Organization
BLOOMWELL MD MEDICAL CORPORATION
Active
Other names
BloomWell M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAOSOLUCHI ENENDU MD (CEO)
(707) 753-2388
Entity
Organization
Contact information
Practice address
333 SUNSET AVE STE 110A, SUISUN CITY, CA 94585-2003
(707) 753-2388
Mailing address
333 SUNSET AVE STE 110A, SUISUN CITY, CA 94585-2003
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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