Individual
MS. JACQUELINE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTC
Contact information
Practice address
4201 TORRANCE BLVD SUITE 190, TORRANCE, CA 90503
(310) 543-2521
Mailing address
24617 AVALON BLVD, WILMINGTON, CA 90744
(424) 477-4674
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
08-0833
CA
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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