Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | A140650 | CA |
NPI | 1316350689 |
---|---|
Provider Name | Emily Jean Martin |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 29/10/2018 |