Provider Demographics
NPI:1447851290
Name:PERFORMANCE ULTRASOUND AND INTERVENTION, PLLC
Entity type:Organization
Organization Name:PERFORMANCE ULTRASOUND AND INTERVENTION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:480-357-6500
Mailing Address - Street 1:8427 E BASELINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-4381
Mailing Address - Country:US
Mailing Address - Phone:480-357-6500
Mailing Address - Fax:480-357-6515
Practice Address - Street 1:8427 E BASELINE RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-4381
Practice Address - Country:US
Practice Address - Phone:480-357-6500
Practice Address - Fax:480-357-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty