Private Medical Consulting

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

G069614 Issued in CA

Legal business name

PRIVATE MEDICAL CONSULTING

Doing business as

David R. Bloom M.D.

Practice address

17822 Beach Blvd Ste 325
Huntington Beach, CA 92647-7519

Phone

(714) 843-6550

Fax

(714) 843-6560

NPI assigned

May 29, 2008

Last updated

May 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ana Macias

Title

Office Manager

Phone

(714) 843-6550

Specialties & licenses 1

Addresses

Other names 1

• David R. Bloom M.D. Doing business as

Locations

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1982862678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 325",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477519",
            "telephone_number": "714-843-6550",
            "fax_number": "714-843-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 325",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477519",
            "telephone_number": "714-843-6550",
            "fax_number": "714-843-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE MEDICAL CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "MACIAS",
        "authorized_official_first_name": "ANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-843-6550"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "G069614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David R. Bloom M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Legal Medicine in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Legal Medicine in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.