Provider Demographics
NPI:1538352356
Name:BLUM CHIROPRACTIC INC.
Entity type:Organization
Organization Name:BLUM CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC27014
Authorized Official - Phone:805-492-1500
Mailing Address - Street 1:31360 VIA COLINAS STE 104
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-6821
Mailing Address - Country:US
Mailing Address - Phone:805-492-1500
Mailing Address - Fax:805-492-1504
Practice Address - Street 1:31360 VIA COLINAS STE 104
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-6821
Practice Address - Country:US
Practice Address - Phone:805-492-1500
Practice Address - Fax:805-492-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB211413OtherMEDICARE ID