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General NPI Number Information
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NPI Number | 1326056466
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Entity Type | Individual
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Provider Name | MONIFA TAMU MARTIN-ROBERTS PA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 9350 FLAIR DR STE 102
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City | EL MONTE
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State | CA
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Zip | 91731-2828
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Country | US
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Telephone | 626-407-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 2118 S MOUNTAIN AVE
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City | ONTARIO
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State | CA
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Zip | 91762-6126
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Country | US
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Telephone | 909-988-9651
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17207
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License Number State | CA
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