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Individual

TINA ABOLHASSANI BLOOMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
4010 E CHAPMAN AVE, SUITE C, ORANGE, CA 92869-3990
(714) 500-0358
(714) 532-3943
Mailing address
19171 JASPER HILL RD, TRABUCO CANYON, CA 92679-1121
(949) 633-9100

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
RN 486773
CA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
NP 10584
CA

Other

Enumeration date
11/15/2006
Last updated
05/08/2012
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