Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CA22072 | CA |
NPI | 1396925780 |
---|---|
Provider Name | Dr. Denise Leeann Martin-Hastings |
First Address | Long Beach, CA 90814-1911 |
Second Address | Long Beach, CA 90814-1911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2007 |
Last Update Date | 21/02/2013 |