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General NPI Number Information
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NPI Number | 1215059662
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Entity Type | Individual
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Provider Name | EMMA F MARTIN NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1600 SAN FERNANDO RD
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City | SAN FERNANDO
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State | CA
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Zip | 91340-3115
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Country | US
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Telephone | 818-365-8086
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Fax | 818-398-4826
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Provider Business Mailing Address
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Address Line | 4955 ARCOLA AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-4811
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Country | US
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Telephone | 818-762-2315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 1888
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License Number State | CA
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