Healthcare Provider Details

I. General information

NPI: 1184251738
Provider Name (Legal Business Name): ERIC MARTIN BLUMENFELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 MURRAY AVE STE 220
SAN LUIS OBISPO CA
93405-2058
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 805-250-2996
  • Fax: 805-250-2998
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA184016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: