Healthcare Provider Details

I. General information

NPI: 1770926636
Provider Name (Legal Business Name): JESSICA BLOOME M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE SAN FRANCISCO GENERAL HOSPITAL
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE SAN FRANCISCO GENERAL HOSPITAL
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-2400
  • Fax:
Mailing address:
  • Phone: 415-206-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA133732
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberA133732
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: