Provider Demographics
NPI:1518963016
Name:ROSENBLOOM, BARRY E (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:E
Last Name:ROSENBLOOM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9090 WILSHIRE BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1850
Mailing Address - Country:US
Mailing Address - Phone:310-888-8680
Mailing Address - Fax:310-888-1886
Practice Address - Street 1:9090 WILSHIRE BLVD
Practice Address - Street 2:STE 200
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1850
Practice Address - Country:US
Practice Address - Phone:310-888-8680
Practice Address - Fax:310-888-1886
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22745207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41705Medicare UPIN