Individual
MR. BASSANIO LAZARO MARTINEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3601 S 6TH AVE, TUCSON, AZ 85723-2510
(520) 792-1450
Mailing address
8323 N SHANNON RD UNIT 6103, TUCSON, AZ 85742-9466
(310) 940-1714
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
59834
CA
363AS0400X
Surgical Physician Assistant
Primary
9567
AZ
Other
Enumeration date
07/22/2021
Last updated
02/14/2023
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