Individual
DOMINIQUE ANTOINETTE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1542 W 125TH ST, LOS ANGELES, CA 90047-5329
(424) 230-9000
(424) 389-7097
Mailing address
1542 W 125TH ST, LOS ANGELES, CA 90047-5329
(424) 230-9000
(424) 389-7097
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
779452
CA
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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