Individual
BRIAN CHRISTOPHER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1505 SOQUEL DR, SUITE 12, SANTA CRUZ, CA 95065-1716
(831) 475-4024
(831) 475-4344
Mailing address
1505 SOQUEL DR, SUITE 12, SANTA CRUZ, CA 95065-1716
(831) 475-4024
(831) 475-4344
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17821
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17821
STATE OF CALIF
CA
Enumeration date
08/15/2006
Last updated
12/30/2021
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