Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 102482 | CA |
NPI | 1003302811 |
---|---|
Provider Name | Julieta Sanchez Martinez |
First Address | Canoga Park, CA 91303-2232 |
Second Address | North Hollywood, CA 91605-3055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2018 |
Last Update Date | 04/07/2018 |