Healthcare Provider Details

I. General information

NPI: 1275350852
Provider Name (Legal Business Name): EDITH ANTONIETA MARTINEZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

3167 TURK BLVD APT 3
SAN FRANCISCO CA
94118-4166
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1000
  • Fax:
Mailing address:
  • Phone: 240-454-2349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number90255
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: