Individual
MARTIN MADRIGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5404 MORENO ST, SUITE N, MONTCLAIR, CA 91763-1667
(909) 949-4400
(909) 949-4441
Mailing address
5404 MORENO ST, SUITE N, MONTCLAIR, CA 91763-1667
(909) 949-4400
(909) 949-4441
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17142
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17142
STATE LICENSE NUMBER
CA
Enumeration date
12/13/2006
Last updated
12/15/2014
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