MEDICARE: MRS. YVONNE CHAMALBIDE MARTINEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SPA 447	CA

General Provider Information

NPI Number	:	1790099034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YVONNE CHAMALBIDE MARTINEZ

Provider Business Mailing Address
First Line	:	12245 183RD ST
Second Line	:
City	:	ARTESIA
State	:	CA
Zip	:	90701-5955
Country	:	US
Telephone Number	:	562-860-1940
Fax Number	:

Provider Business Practice Location Address
First Line	:	433 N 4TH ST STE 101
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4313
Country	:	US
Telephone Number	:	323-722-8610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	07/28/2010

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Directions to “ MRS. YVONNE CHAMALBIDE MARTINEZ ” Practice Location

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