Individual
MRS. BROOKE LORRAINE BLOMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27699 JEFFERSON AVE, TEMECULA, CA 92590-2661
(951) 695-4688
Mailing address
10392 GLEN ROCK CIR, MORENO VALLEY, CA 92557-2692
(951) 903-6931
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
B2084708
CA
363A00000X
Physician Assistant
Primary
—
CA
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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