| Doctor Name: | MR. MICHAEL ALLEN BLOOM |
| NPI Number: | 1336594456 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS |
| License Number: | 10031 |
| Business Practice Address: | 4150 Clement St # 126 San Francisco, CA - 941211545 |
| Business Phone Number: | 4157502237 |
| Business Fax Number: | |
| Mailing Address: | 3217 Vicente St Apt 3, SAN FRANCISCO |
| State: | CA |
| Postal Code: | 941162653 |
| Phone Number: | 9259151080 |
| Fax Number: | |
| NPI Enumeration Date: | 04/26/2016 |
| NPI Last Update Date: | 04/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 10031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |