Healthcare Provider Details

I. General information

NPI: 1770007262
Provider Name (Legal Business Name): ADRIANA E MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S. OLIVE STREET SUITE 1400
LOS ANGELES CA
90015-2212
US

IV. Provider business mailing address

1150 S. OLIVE STREET SUITE 1400
LOS ANGELES CA
90015
US

V. Phone/Fax

Practice location:
  • Phone: 213-821-5977
  • Fax:
Mailing address:
  • Phone: 213-821-5977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: