Kenneth Joel Bloom, M.D.

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

G86592 Issued in CA

Practice address

31 Columbia
CPS
Aliso Viejo, CA 92656-1460

Phone

(949) 425-5744

Fax

(949) 425-5865

NPI assigned

Sep 2, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1023399177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 COLUMBIA",
            "address_2": "CPS",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561460",
            "telephone_number": "949-425-5744",
            "fax_number": "949-425-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 COLUMBIA",
            "address_2": "CPS",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561460",
            "telephone_number": "949-425-5744",
            "fax_number": "949-425-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "KENNETH",
        "middle_name": "JOEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "G86592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Rachelle Bigda, CPM, LM
• Shahnam Zand Biglari, PHARMD, BCNP
• Reza Mohammad Birjandi, DDS
• Paul Bishop
• Mindy Kaye Bixby, D.O.
• Tracy L Blum, PT
• Peter Franklin Gene Boller, PT
• Aaron Bradley Boor, D.O.
• Mahdis Bormand, LMFT
• Somayeh Boroumandi

• Anatomic Pathology Physician in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Anatomic Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.