Individual
MARTHA VANESSA STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(619) 543-7467
Mailing address
1006 9TH ST, IMPERIAL BEACH, CA 91932-2802
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH25658
CA
Other
Enumeration date
01/13/2026
Last updated
01/13/2026
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