Bloom, Myron J

Bloom, Myron J is an individual health care provider with primary practice located at 3801 Katella Ave Suite 212, Los Alamitos CA 90720-3381. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Bloom, Myron J can be contacted via phone (562) 596-4645.

Contact Information

Primary practice address
3801 Katella Ave Suite 212 Los Alamitos CA 90720-3381
Phone: (562) 596-4645
Fax: (562) 596-2225
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X G17159 California

Profile Details

NPI number 1881608370
LBN Legal business name Bloom, Myron J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Jul 8th, 2007 - about 18 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 1881608370 NPPES
California MEDICAID 00G171590

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