DR. MITCHELL EDWARD BLUM (NPI# 1770586448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770586448 |
| Entity Type | Individual |
| Full Name | DR. MITCHELL EDWARD BLUM |
| Credential | M.D. |
| Practice Address |
2160 W. Grantline Rd Suite 250 Tracy CA 95377 |
| Mailing Address |
15 Oval Rd Oakland CA 94611 |
| Practice Telephone | 2098340626 |
| Practice Fax Number | 2098341814 |
| Mailing Telephone | 2098340626 |
| Mailing Fax Number | 5108174235 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2015-04-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | G25010 | CA | Allopathic & Osteopathic Physicians |
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
G25010 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G250100 | 05 |
| Street Address |
2160 W. GRANTLINE RD SUITE 250 |
| City | TRACY |
| State | CA |
| Zip Code | 95377 |
| 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 |
| 1457396897 | Florence Leguiab Wandisan-rosete | Internal Medicine | 4600 S Tracy Blvd, #107, Tracy, CA 95377 | 2006-06-19 |
| Find all providers in zip 95377 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548877590 | Sleep Apnea Surgery Center Inc. | Otolaryngology | 1900 University Avenue, East Palo Alto, CA 94303 | 2020-09-24 |
| 1922613207 | Resurgent Head and Neck Surgeons, Inc. | Otolaryngology | 6848 Magnolia Ave Ste 220, Riverside, CA 92506-2858 | 2020-09-13 |
| 1427682764 | Angela A Chang Md A Professional Corporation | Otolaryngology | 9834 Genesee Ave Ste 112, La Jolla, CA 92037-1214 | 2020-02-25 |
| 1376176164 | Jaime Munroe | Otolaryngology | 5333 Hollister Ave Ste 155, Santa Barbara, CA 93111-2444 | 2020-02-19 |
| 1003389107 | James Jaber Md A Medical Corporation | Otolaryngology | 850 S Atlantic Blvd Ste 305, Monterey Park, CA 91754-6714 | 2019-01-10 |
| 1033680996 | Ent Medical and Surgical Care | Otolaryngology | 100 Casa St Ste B100, San Luis Obispo, CA 93405-1883 | 2018-12-17 |
| 1477041952 | Ira Harold Buchalter | Otolaryngology | 2029 Tempranillo Ln, Brentwood, CA 94513-5291 | 2018-04-30 |
| 1316435670 | Gregory E. Washington, M.d., A Medical Corporation | Otolaryngology | 3655 Lomita Blvd Ste 321, Torrance, CA 90505-1927 | 2018-04-23 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| 1710480140 | Jill Mazza, M.d., A Professional Corporation | Otolaryngology | 191 S Buena Vista St Ste 320, Burbank, CA 91505-4556 | 2018-03-12 |
| Find all providers with the same taxonomy | ||||
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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.