Organization
JEANNETTE MARTELLO MD A PROFESSIONAL CORPORATION
Active
Other names
Skin Deep
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNETTE YVETTE MARTELLO M.D. (PRESIDENT)
(626) 403-1747
Entity
Organization
Contact information
Practice address
701 FREMONT AVE, SOUTH PASADENA, CA 91030-2529
(626) 403-1747
(626) 403-1784
Mailing address
701 FREMONT AVE, SOUTH PASADENA, CA 91030-2529
(626) 403-1747
(626) 403-1784
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G066298
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245452424
INDIVIDUAL PROVIDER NPI
CA
Enumeration date
01/13/2009
Last updated
02/09/2009
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