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General NPI Number Information
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NPI Number | 1659240018
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Entity Type | Organization
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Legal Business Name | BLOOM ORTHOPEDIC PHYSICAL THERAPY
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 830 STEWART DR STE 137
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City | SUNNYVALE
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State | CA
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Zip | 94085-4513
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Country | US
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Telephone | 408-520-1499
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Fax |
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Provider Business Mailing Address
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Address Line | 520 E WEDDELL DR APT 361
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City | SUNNYVALE
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State | CA
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Zip | 94089-2078
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Country | US
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Telephone | 858-220-5833
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | PEIRUN CHEN
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Credential | DPT
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Telephone | 858-220-5833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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