Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A 98572 | CA |
N | 207KA0200X | Allergist | A 98572 | CA |
N | 207RA0201X | Internist - Allergy & Immunology | A 98572 | CA |
N | 2080P0201X | Pediatric Allergist | A98572 | CA |
NPI | 1316164106 |
---|---|
Provider Name | Jamila C. Martin |
First Address | Mountain View, CA 94040-6201 |
Second Address | Mountain View, CA 94040-2833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 09/12/2011 |