Healthcare Provider Details

I. General information

NPI: 1326507385
Provider Name (Legal Business Name): MAX JACOB BLUMBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 POST ST STE 460
SAN FRANCISCO CA
94115-3466
US

IV. Provider business mailing address

2330 POST ST STE 460
SAN FRANCISCO CA
94115-3466
US

V. Phone/Fax

Practice location:
  • Phone: 415-885-7580
  • Fax: 415-514-5614
Mailing address:
  • Phone: 415-885-7580
  • Fax: 415-514-5614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA180291
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberA180291
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: