Individual
STEPHANIE JEANNE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16260 VENTURA BLVD, ENCINO, CA 91436-2203
(818) 788-4022
Mailing address
16260 VENTURA BLVD, ENCINO, CA 91436-2203
(818) 788-4022
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
A122824
CA
Other
Enumeration date
05/02/2012
Last updated
11/16/2017
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