Bloom, Jessica

Bloom, Jessica is an sole proprietor health care provider with primary practice located at 200 W Arbor Dr # Mc8465 , San Diego CA 92103-1911. She recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Bloom, Jessica can be contacted via phone (858) 657-7000.

Contact Information

Primary practice address
200 W Arbor Dr # Mc8465 San Diego CA 92103-1911
Phone: (858) 657-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 125.078268 Illinois
Allopathic & Osteopathic Physicians / Neurology 2084N0400X A182564 California

Profile Details

NPI number 1588287387
LBN Legal business name Bloom, Jessica
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 27th, 2020
Last updated Nov 15th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588287387 NPPES
Illinois Other 125.078268 TEMPORARY MEDICAL PERMIT (IDFPR)
Illinois Other A182564 TEMPORARY MEDICAL PERMIT (IDFPR)

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