| Jeffrey M. Bloom M.d. Inc | |
|
1318 Johnson Ave San Luis Obispo CA 93401-3314 | |
| (805) 541-2300 | |
| (805) 541-2301 |
| Full Name | Jeffrey M. Bloom M.d. Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1318 Johnson Ave, San Luis Obispo, California |
| Authorized Official Name and Position | Jeffrey M Bloom (PRESIDENT) |
| Authorized Official Contact | 8055412300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey M. Bloom M.d. Inc 1318 Johnson Ave San Luis Obispo CA 93401-3314 Ph: (805) 541-2300 | Jeffrey M. Bloom M.d. Inc 1318 Johnson Ave San Luis Obispo CA 93401-3314 Ph: (805) 541-2300 |
| NPI Number | 1457781841 |
|---|---|
| Provider Enumeration Date | 11/21/2013 |
| Last Update Date | 08/04/2022 |
| Medicare PECOS PAC ID | 0042433062 |
|---|---|
| Medicare Enrollment ID | O20140520002257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457781841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeffrey M Bloom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154346377 PECOS PAC ID: 4789637356 Enrollment ID: I20100323000500 |
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