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Individual

ANITA BOORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
9930 TALBERT AVE., FOUNTAIN VALLEY, CA 92708
(714) 964-6229
(714) 378-6233
Mailing address
9930 TALBERT AVE., FOUNTAIN VALLEY, CA 92708

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20A7268
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0020A72680
MEDI CAL #
CA
Enumeration date
06/17/2005
Last updated
09/22/2008
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