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General NPI Number Information
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NPI Number | 1730639683
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Entity Type | Organization
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Legal Business Name | BLOOM OBSTETRICS AND GYNECOLOGY, INC
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 18555 VENTURA BLVD SUITE C
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City | TARZANA
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State | CA
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Zip | 91356-4192
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Country | US
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Telephone | 209-613-2927
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Fax |
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Provider Business Mailing Address
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Address Line | 18555 VENTURA BLVD SUITE C
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City | TARZANA
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State | CA
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Zip | 91356-4192
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEETU KHURANA SODHI
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Credential | D.O.
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Telephone | 818-723-9153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 20A12852
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License Number State | CA
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