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NPI Code Detail

MEDICARE: HEATHER MARTIN PHARMD

MEDICARE: HEATHER MARTIN PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist54018CA
2183500000XPharmacistPS35860FL

General Provider Information

NPI Number : 1023105517
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER MARTIN PHARMD
Provider Business Mailing Address
First Line : 1550 GATEWAY BLVD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6901
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1550 GATEWAY BLVD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6901
Country : US
Telephone Number : 707-427-4302
Fax Number : 707-427-4380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 07/08/2007

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Directions to “ HEATHER MARTIN PHARMD” Practice Location

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