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General NPI Number Information
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NPI Number | 1780056812
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Entity Type | Individual
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Provider Name | EUGENE ROSENBLOOM MD
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Gender | Male
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 2801 K ST
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City | SACRAMENTO
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State | CA
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Zip | 95816-5120
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Country | US
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Telephone | 916-549-6636
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Fax |
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Provider Business Mailing Address
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Address Line | 5110 DEL RIO RD
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City | SACRAMENTO
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State | CA
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Zip | 95822-2517
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G32945
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License Number State | CA
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