Corey-Bloom, Jody

Corey-Bloom, Jody is an sole proprietor health care provider with primary practice located at 8950 Villa La Jolla Dr C129, La Jolla CA 92037-1714. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Corey-Bloom, Jody can be contacted via phone (858) 246-1288.

Contact Information

Primary practice address
8950 Villa La Jolla Dr C129 La Jolla CA 92037-1714
Phone: (858) 246-1288
Fax: (858) 246-1283
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X G062847 California

Profile Details

NPI number 1053400093
LBN Legal business name Corey-Bloom, Jody
Credentials MD, PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2006
Last updated Apr 6th, 2016 - about 10 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 1053400093 NPPES
California Other 00G628470C06 CALOPTIMA PROVIDER NUMBER
California Other 4845 CALOPTIMA PROVIDER NUMBER
California Other 130007027 CALOPTIMA PROVIDER NUMBER
California MEDICAID 00G628470 CALOPTIMA PROVIDER NUMBER

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