Healthcare Provider Details

I. General information

NPI: 1477041069
Provider Name (Legal Business Name): MARTIN ARAMBULA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2018
Last Update Date: 04/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 CORPORATE TERRACE CIR
CORONA CA
92879-6028
US

IV. Provider business mailing address

28301 ENCANTO DR APT 81
SUN CITY CA
92586-3359
US

V. Phone/Fax

Practice location:
  • Phone: 714-881-0427
  • Fax:
Mailing address:
  • Phone: 951-870-7031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: