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General NPI Number Information
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NPI Number | 1124788369
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Entity Type | Organization
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Legal Business Name | BLOSSOMING HEALTH
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 830 STEWART DR # 140
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City | SUNNYVALE
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State | CA
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Zip | 94085-4513
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Country | US
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Telephone | 650-554-0753
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W WEDDELL DR APT 241
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City | SUNNYVALE
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State | CA
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Zip | 94089-1580
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALIAA ALDINE
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Credential | LAC, DAOM
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Telephone | 650-554-0753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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