Individual
ADITAIM LOPEZ MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
13522 NEWPORT AVE, UNIT 200, TUSTIN, CA 92780-3707
(800) 658-5877
Mailing address
1354 KILBY LN, VISTA, CA 92083-7166
(760) 845-0363
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95004455
CA
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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