Individual
ELISA R. MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2101 TENAYA DR, MODESTO, CA 95354-3930
(209) 576-6766
(209) 576-6776
Mailing address
737 W CHILDS AVE, MERCED, CA 95340-6805
(209) 383-1848
(209) 383-1296
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12678
CA
Other
Enumeration date
11/22/2005
Last updated
11/07/2013
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