Individual
LINNINEA BOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11175 CAMPUS ST, SUITE 11120, LOMA LINDA, CA 92350-1700
(909) 558-0440
Mailing address
11175 CAMPUS ST, LOMA LINDA, CA 92350-1700
(909) 558-8242
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95003686
CA
Other
Enumeration date
04/23/2016
Last updated
03/16/2023
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