Healthcare Provider Details

I. General information

NPI: 1386830693
Provider Name (Legal Business Name): BEATRIS MARTINEZ RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 TORRANCE BLVD
TORRANCE CA
90503-4504
US

IV. Provider business mailing address

4201 TORRANCE BLVD
TORRANCE CA
90503-4504
US

V. Phone/Fax

Practice location:
  • Phone: 310-540-5503
  • Fax: 310-792-3694
Mailing address:
  • Phone: 310-540-5503
  • Fax: 310-792-3694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number482986
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number16248
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number16248
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: