Healthcare Provider Details

I. General information

NPI: 1467394874
Provider Name (Legal Business Name): BLOOM MEDICAL GROUP CA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10409 WITHIN HEIGHTS DR
BAKERSFIELD CA
93311-4924
US

IV. Provider business mailing address

8 CAMPUS DR STE 105
PARSIPPANY NJ
07054-4409
US

V. Phone/Fax

Practice location:
  • Phone: 866-972-8228
  • Fax: 973-636-4972
Mailing address:
  • Phone: 551-293-6969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2278P1005X
TaxonomyPulmonary Rehabilitation Certified Respiratory Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: GABRIEL SALAS
Title or Position: MANAGER
Credential:
Phone: 551-293-6969