Provider Demographics
NPI:1093851727
Name:BLUMBERG, MARC HELMAN (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:HELMAN
Last Name:BLUMBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 830
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92546-0830
Mailing Address - Country:US
Mailing Address - Phone:951-791-3300
Mailing Address - Fax:951-791-3333
Practice Address - Street 1:650 N STATE ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-2960
Practice Address - Country:US
Practice Address - Phone:951-791-3300
Practice Address - Fax:951-791-3333
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA337502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry