Individual
BEVERLY GRACE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
813 ADELITA ST, MONTEBELLO, CA 90640-2504
(213) 804-0055
Mailing address
813 ADELITA ST, MONTEBELLO, CA 90640-2504
(213) 804-0055
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN169181
CA
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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