Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 30743 | CA |
NPI | 1306018809 |
---|---|
Provider Name | Dr. Pia Martin |
First Address | Carlsbad, CA 92009-6374 |
Second Address | San Diego, CA 92130-2049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2008 |
Last Update Date | 10/07/2014 |