Jeffrey Bloom D.o. Inc, DBA Back Bay Medical
NPI #1538405220 in Newport Beach, California
Provider Information
- NPI Number
- 1538405220
- Entity Type
- Organization
- Organization Name
- Jeffrey Bloom D.o. Inc, DBA Back Bay Medical
- Primary Specialty
- Family Medicine - Sports Medicine
- Enumeration Date
- Dec 27, 2012
- Last Updated
- Dec 27, 2012
Practice Location
- Address
- 20311 SW ACACIA ST
- Address 2
- #100
- City
- Newport Beach
- State
- California
- ZIP Code
- 92660-1733
- Phone
- (949) 263-1242
Authorized Official
- Name
- DR. JEFFREY HOWARD BLOOM, D.O.
- Title
- OWNER
- Phone
- (949) 263-1242
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Sports Medicine — Sports Medicine |
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