Individual
DR. MARTA LUKAS SOVYANHADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2198 CORDILLERA AVE, COLTON, CA 92324-9517
(190) 972-3061
(909) 723-0611
Mailing address
2198 CORDILLERA AVE, COLTON, CA 92324-9517
(190) 972-3061
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
861239
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-1681721
DIABETES, RENAL, HYPERTENSION AND OTHER LIFE STYLE CHRONIC DISEASES
CA
Enumeration date
03/05/2021
Last updated
03/05/2021
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