Provider Type Icon

MICHAEL GARY BLOOM MD NPI 1821197591


NPI Information

NPI: 1821197591
Provider Name: MICHAEL GARY BLOOM, MD
Classification: Neuromusculoskeletal Medicine, Sports Medicine - 204C00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
15243 VAN OWEN ST #403
VAN NUYS, CA
ZIP 91405
Phone: (818) 988-8800
Get Directions

Michael Gary Bloom, MD is a neuromusculoskeletal medicine sports medicine in Van Nuys, CA. The provider is a Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/ Michael Gary Bloom, MD NPI is 1821197591. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

15243 VAN OWEN ST #403
VAN NUYS, CA
ZIP 91405
Phone: (818) 988-8800
Fax: (818) 988-3416

The NPI 1821197591 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/21/2006 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204C00000XNeuromusculoskeletal Medicine, Sports MedicineA23832CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A23832MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIACALIF LICENSE
2A82878MEDICARE UPINCALIFORNIA
300A238320MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.