MITCHELL E. BLUM M.D., F.A.C.S., INC. (NPI# 1356717854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356717854 |
| Entity Type | Organization |
| Organization Name | MITCHELL E. BLUM M.D., F.A.C.S., INC. |
| Practice Address |
2160 W Grant Line Rd Suite 250 Tracy CA 95377-7330 |
| Practice Telephone | 2098340626 |
| Practice Fax Number | 2098341814 |
| Mailing Telephone | 2098340626 |
| Mailing Fax Number | 2098341814 |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-09-23 |
| Authorized Official Name | MITCHELL E. BLUM (CEO) |
| Authorized Official Telephone | 2098340626 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
G25010 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2160 W GRANT LINE RD SUITE 250 |
| City | TRACY |
| State | CA |
| Zip Code | 95377-7330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982608683 | Thomas B Mcnemar | Plastic Surgery | 2160 W Grant Line Rd, Suite 250, Tracy, CA 95377-7330 | 2005-06-09 |
| 1902200066 | George Shiao, Dmd | Dentist | 2160 W Grant Line Rd, Suite 220, Tracy, CA 95377-7330 | 2014-10-20 |
| 1386816205 | Grant Line Pharmacy Inc | Pharmacy | 2160 W Grant Line Rd, Ste 205, Tracy, CA 95377-7330 | 2008-04-01 |
| 1184812851 | Delta Eye Medical Group, Inc. | Ophthalmology | 2160 W Grant Line Rd, Suite 100, Tracy, CA 95377-7330 | 2007-10-09 |
| 1013104389 | Tracy Surgery Center, LLC | Clinic/Center | 2160 W Grant Line Rd, Suite 120, Tracy, CA 95377-7330 | 2007-10-01 |
| 1427166685 | Hana Rha Lim | Optometrist | 2160 W Grant Line Rd, Suite 100, Tracy, CA 95377-7330 | 2006-08-28 |
| 1962519652 | Pamela Y Tsuchiya | Ophthalmology | 2160 W Grant Line Rd, Suite 100, Tracy, CA 95377-7330 | 2006-08-25 |
| 1265453872 | Tracy Urgent Care, Inc | Internal Medicine | 2160 W Grant Line Rd, Ste.230, Tracy, CA 95377-7330 | 2006-07-21 |
| 1154355832 | Usman M Ali | Internal Medicine | 2160 W Grant Line Rd, Ste 230, Tracy, CA 95377-7334 | 2006-07-10 |
| 1700818168 | Thomas B Mcnemar Md Inc | Plastic Surgery | 2160 W Grant Line Rd, Suite 250, Tracy, CA 95377-7330 | 2006-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639787070 | Mehak Bhardwaj | Behavior Technician | 2434 Saffron Ct, Tracy, CA 95377 | 2020-07-22 |
| 1427510809 | Xiaorui Yang | Behavior Technician | 1951 W Middlefield Dr Apt 224, Tracy, CA 95377 | 2019-04-03 |
| 1962936328 | Duc Nguyen | Pharmacist | 2941 W. Lowell Ave, Apt# 21, Tracy, CA 95377 | 2017-04-12 |
| 1053735043 | Luke Rond | Emergency Medicine | 763 Quail Run Cir, Tracy, CA 95377 | 2014-02-11 |
| 1578862553 | Nhan Duong | Pharmacist | 3250 W. Grant Line Road, Tracy, CA 95377 | 2011-03-16 |
| 1952570582 | Tech Diamond Health Care | Home Health | 2098 Babcock Lane, Tracy, CA 95377 | 2008-02-28 |
| 1316058795 | Wandisan and Rosete Medical Group Professional Corporation | Internal Medicine | 4600 S Tracy Blvd #107, Tracy, CA 95377 | 2006-08-31 |
| 1801838610 | Rollie Duyao Rosete | Internal Medicine | 4600 S Tracy Blvd, #107, Tracy, CA 95377 | 2006-06-13 |
| 1649274663 | Wivina Talabis Urbano | Pediatrics | 4600 South Tracy Blvd, Suite 110, Tracy, CA 95377 | 2005-06-08 |
| 1770586448 | Mitchell Edward Blum | Otolaryngology | 2160 W. Grantline Rd, Suite 250, Tracy, CA 95377 | 2005-05-24 |
| Find all providers in zip 95377 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114550498 | Hootan Zandifar Md Inc | Otolaryngology | 8920 Wilshire Blvd Ste 604, Beverly Hills, CA 90211-2006 | 2020-02-14 |
| 1548751183 | Farhad Ardesh Md Inc | Otolaryngology | 11620 Wilshire Blvd Ste 280, Los Angeles, CA 90025-1263 | 2018-05-18 |
| 1174943377 | Sunny Park Md, Inc | Otolaryngology | 901 Dover Dr Ste 126, Newport Beach, CA 92660-5546 | 2014-04-26 |
| 1154743987 | Keith Jay Wahl | Otolaryngology | 8735 Nottingham Pl, La Jolla, CA 92037-2129 | 2014-01-14 |
| 1295179570 | Ari Joseph Hyman | Otolaryngology | 16311 Ventura Blvd Ste 600, Encino, CA 91436-2134 | 2013-04-17 |
| 1710229893 | Zachary Calnan Fridirici | Otolaryngology | 2233 Post St Fl 3, San Francisco, CA 94115 | 2013-03-26 |
| 1376883975 | Su Mai | Otolaryngology | 13071 Brookhurst St Ste 150, Garden Grove, CA 92843-1024 | 2013-02-20 |
| 1710244892 | Meaghan Noud | Otolaryngology | 421 Post St Fl 14, San Francisco, CA 94102 | 2012-04-13 |
| 1508164500 | Dr. Sasha Maher D.o. | Otolaryngology | 10861 Cherry St Ste 106, Los Alamitos, CA 90720-5403 | 2011-03-01 |
| 1871804187 | Edwin E Breitenbach | Otolaryngology | 2601 Augusta, Tustin, CA 92782-1201 | 2010-07-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MITCHELL E. BLUM M.D., F.A.C.S., INC..
| 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.