Stuart Bloom PHD

NPI 1194919670 - Marriage & Family Therapist - 106H00000X

NPI Details
NPI 1194919670
Gender Male
Enumeration Date 08/28/2007
Last Updated 08/28/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1395 CERRITOS DR
LAGUNA BEACH CA, 92651-2816, US
Phone (949) 497-6767
Fax
Business Location
1395 CERRITOS DR
LAGUNA BEACH CA, 92651-2816, US
Phone (949) 497-6767
Fax
Toxanomy
Taxonomy Code 106H00000X
License State California
License Number MFT12112
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According to our database, Dr. Stuart Bloom PHD NPI is 1194919670, taxonomy code is 106H00000X and license number is MFT12112, license state is located at California. Stuart Bloom PHD physically located at 1395 Cerritos Dr, Laguna Beach CA, 92651-2816. NPI Number Stuart Bloom PHD has the Individual type.

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1194919670 NPI number is provided on an as is basis without warranty of any kind. 1194919670 is maintained by the National Plan & Provider Enumeration System. The contents of Stuart Bloom PHD are for informational purposes only.