Individual
MARCO MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
754 MEDICAL CENTER CT, CHULA VISTA, CA 91911-6654
(619) 421-4000
(619) 421-6395
Mailing address
754 MEDICAL CENTER CT, CHULA VISTA, CA 91911-6654
(619) 421-4000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
95005530
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95005530
CA
Other
Enumeration date
12/07/2016
Last updated
06/16/2020
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