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General NPI Number Information
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NPI Number | 1467394874
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Entity Type | Organization
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Legal Business Name | BLOOM MEDICAL GROUP CA PC
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 284 W SHAW AVE
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City | CLOVIS
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State | CA
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Zip | 93612-3601
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Country | US
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Telephone | 551-293-6969
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CAMPUS DR STE 105
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City | PARSIPPANY
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State | NJ
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Zip | 07054-4409
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Country | US
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Telephone | 551-293-6969
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | GABRIEL SALAS
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Credential |
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Telephone | 551-293-6969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC3500X
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Taxonomy Name | Cardiac Rehabilitation Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 364SR0400X
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Taxonomy Name | Rehabilitation Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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