Individual
LORENA ANDREA VIVANCO DE MARTINEZ
Active
Individual
LORENA ANDREA VIVANCO DE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A73493
CA
2080C0008X
Child Abuse Pediatrics Physician
Primary
A73493
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A734930
—
CA
Enumeration date
11/13/2006
Last updated
10/27/2017
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