Provider Demographics
NPI:1659240018
Name:BLOOM ORTHOPEDIC PHYSICAL THERAPY
Entity type:Organization
Organization Name:BLOOM ORTHOPEDIC PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEIRUN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:858-220-5833
Mailing Address - Street 1:520 E WEDDELL DR APT 361
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94089-2078
Mailing Address - Country:US
Mailing Address - Phone:858-220-5833
Mailing Address - Fax:
Practice Address - Street 1:830 STEWART DR STE 137
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4513
Practice Address - Country:US
Practice Address - Phone:408-520-1499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty