David-James Bloom, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G47414 Issued in CA

Practice address

990 Sonoma Ave
17
Santa Rosa, CA 95404-4802

Phone

(707) 575-3500

Fax

(707) 575-3530

NPI assigned

Apr 24, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1699731133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SONOMA AVE",
            "address_2": "17",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044802",
            "telephone_number": "707-575-3500",
            "fax_number": "707-575-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SONOMA AVE",
            "address_2": "17",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044802",
            "telephone_number": "707-575-3500",
            "fax_number": "707-575-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "DAVID-JAMES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G47414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G474140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Danielle Bleck
• Wolfgang R. Bley, MD
• Conrad E Block, DDS
• Mitchell Blomseth
• Blood Bank of the Redwoods
• Richard Bloom, MFT
• Lorraine Blue, MFT
• Lisa Marie Boardman, MPT
• Gwendolyn A. Boatman, MD
• Pamela A Boaz, PHD MFT

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.