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NPI Code Detail

MEDICARE: SYDNEY ALEXANDRA BLUM

MEDICARE: SYDNEY ALEXANDRA BLUM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantCA

General Provider Information

NPI Number : 1467281915
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY ALEXANDRA BLUM
Provider Business Mailing Address
First Line : 6330 SAN VICENTE BLVD STE 310
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-5468
Country : US
Telephone Number : 310-855-0751
Fax Number :
Provider Business Practice Location Address
First Line : 588 LONGMEADOW ST
Second Line :
City : LONGMEADOW
State : MA
Zip : 01106-2212
Country : US
Telephone Number : 413-565-1317
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2024
Last Update Date : 03/02/2026

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Directions to “ SYDNEY ALEXANDRA BLUM ” Practice Location

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