JEFFREY BLOOM D.O. INC, DBA BACK BAY MEDICAL (NPI# 1538405220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538405220 |
| Entity Type | Organization |
| Organization Name | JEFFREY BLOOM D.O. INC, DBA BACK BAY MEDICAL |
| Practice Address |
20311 Sw Acacia St #100 Newport Beach CA 92660-1733 |
| Practice Telephone | 9492631242 |
| Practice Fax Number | 9492631280 |
| Mailing Telephone | 9492631242 |
| Mailing Fax Number | 9492631280 |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2012-12-27 |
| Authorized Official Name | DR. JEFFREY HOWARD BLOOM (OWNER) |
| Authorized Official Telephone | 9492631242 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
20A6397 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
20311 SW ACACIA ST #100 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-1733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669472148 | Jeffrey Howard Bloom | Family Medicine | 20311 Sw Acacia St, Suite 100, Newport Beach, CA 92660-1733 | 2005-07-27 |
| 1417197443 | Gregory A Robertson Md A Professional Medical Corporation | Internal Medicine | 20311 Sw Acacia St, Ste 100, Newport Beach, CA 92660-1733 | 2009-03-04 |
| 1932281011 | Gregory A Robertson | Internal Medicine | 20311 Sw Acacia St, Ste 100, Newport Beach, CA 92660-1733 | 2006-10-19 |
| 1073528469 | Back Bay Medical LLC | Clinic/Center | 20311 Sw Acacia St, Suite 140, Newport Beach, CA 92660-1733 | 2006-07-31 |
| 1487609939 | Russell S. Alterman | Internal Medicine | 20311 Sw Acacia St, Suite 100, Newport Beach, CA 92660-1733 | 2006-05-23 |
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| 1205445798 | Felecia A Pedrogo | Marriage & Family Therapist | 5020 Campus Street, Newport Beach, CA 92660 | 2020-07-30 |
| 1649898388 | Polyviou Dental Corportation, Inc. | Clinic/Center | 120 Newport Beach Drive, Suite 27, Newport Beach, CA 92660 | 2020-07-09 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1902366925 | Yasmine Central Gohar | Marriage & Family Therapist | 20271 Sw Birch St Ste 200, Newport Beach, CA 92660 | 2019-03-25 |
| 1245703255 | Charison Counseling | Counselor | 4000 Macarthur Bvd Suite 600 East Tower, Newport Beach, CA 92660 | 2019-01-03 |
| 1134698996 | Amber Werner | Chiropractor | 4029 Westerly Place, Suite #115, Newport Beach, CA 92660 | 2018-11-21 |
| 1861969008 | Healthy Me Oc | Dietitian, Registered | 4569 Macarthur Court, Suite 1100, Newport Beach, CA 92660 | 2018-10-25 |
| 1174015192 | Edwin Enwia | Clinic/Center | 1000 Bristol St N Ste 1b, Newport Beach, CA 92660 | 2018-06-05 |
| Find all providers in zip 92660 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669472148 | Jeffrey Howard Bloom | Family Medicine | 20311 Sw Acacia St, Suite 100, Newport Beach, CA 92660-1733 | 2005-07-27 |
| 1740549278 | Cambria Anne Judd | Family Medicine | 500 Superior Ave Ste 100, Newport Beach, CA 92663 | 2012-05-03 |
| 1396030763 | Emilia Ravski | Family Medicine | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2011-06-14 |
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| 1124596010 | Cam Md | Family Medicine | 1968 S Coast Hwy # 401, Laguna Beach, CA 92651-3681 | 2018-11-08 |
| 1902289226 | Daesoon Leem | Family Medicine | 15095 Amargosa Rd, Bldg.1, #102, Victorville, CA 92394 | 2015-07-06 |
| 1114313616 | Michelle Sriwongtong | Family Medicine | 834 Castro St, 3, San Francisco, CA 94114-2858 | 2015-04-10 |
| 1225433006 | Harut Madatovian | Family Medicine | 2595 E Washington Blvd Ste 106, Pasadena, CA 91107-1409 | 2014-10-23 |
| 1760801880 | Kyle William Meyer | Family Medicine | 24910 Las Brisas Rd Ste 105, Murrieta, CA 92562 | 2014-04-16 |
| 1720403553 | Dianne Longo | Family Medicine | 1319 Evergreen Ave, Apt N2, Fullerton, CA 92835-2063 | 2014-03-03 |
| 1255760633 | Steven William Marles | Family Medicine | 4265 Tapestry Way, Turlock, CA 95382-7448 | 2013-11-05 |
| 1497098909 | Joshua David Sampson | Family Medicine | 2299 Post St Ste 107, San Francisco, CA 94115-3460 | 2013-04-03 |
| 1699015529 | Andrew Saleh | Family Medicine | 1370 Rosecrans St Ste A, San Diego, CA 92106-2676 | 2013-03-01 |
| Find all providers with the same taxonomy | ||||
| City | NEWPORT BEACH |
| Zip Code | 92660 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.