Provider Demographics
NPI:1346580230
Name:MARTINEZ, JENNIFER S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:S
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19300 S HAMILTON AVE
Mailing Address - Street 2:STE 170
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-4400
Mailing Address - Country:US
Mailing Address - Phone:310-464-8241
Mailing Address - Fax:
Practice Address - Street 1:19300 S HAMILTON AVE
Practice Address - Street 2:STE 170
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4400
Practice Address - Country:US
Practice Address - Phone:310-464-8241
Practice Address - Fax:310-771-0621
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist