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1023399177
KENNETH JOEL BLOOM
ALISO VIEJO, CA
NPI
1023399177
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207ZP0101X Pathology Anatomic Pathology
(Licence: CA G86592)
Enumeration Date
2011-09-02
Last Update Date
2011-09-02
Business Address
KENNETH JOEL BLOOM M.D.
31 COLUMBIA CPS
ALISO VIEJO, CA 92656-1460
Phone number: 949-425-5744
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Mailing Address
KENNETH JOEL BLOOM M.D.
31 COLUMBIA CPS
ALISO VIEJO, CA 92656-1460
Phone number: 949-425-5744
Copy
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