Individual
JACK MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5500 CAMPANILE DR, SAN DIEGO, CA 92182-0003
(619) 594-5200
Mailing address
943 HAWTHORNE DR, WALNUT CREEK, CA 94596-6137
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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