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1457892580
TIMOTHY BLOOM
TARZANA, CA
NPI
1457892580
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
283Q00000X Psychiatric Hospital
(Licence: CA 930000163)
Enumeration Date
2017-03-08
Last Update Date
2017-03-08
Business Address
-- TIMOTHY BLOOM
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
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Mailing Address
-- TIMOTHY BLOOM
12280 WINDMERE AVE
SYLMAR, CA 91342-5156
Phone number: 818-287-9177
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