Provider Demographics
NPI:1326406976
Name:MARTINEZ, LILY (MPH, CHES, IBCLC)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MPH, CHES, IBCLC
Other - Prefix:
Other - First Name:LILIANA
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6715 BANDA AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-3738
Mailing Address - Country:US
Mailing Address - Phone:562-618-5751
Mailing Address - Fax:
Practice Address - Street 1:6715 BANDA AVE
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-3738
Practice Address - Country:US
Practice Address - Phone:562-618-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN