Provider Demographics
NPI:1619255239
Name:SAN MARTIN, MARTA E (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:E
Last Name:SAN MARTIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9843 CHESAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:ALTA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-5956
Mailing Address - Country:US
Mailing Address - Phone:909-527-4020
Mailing Address - Fax:909-527-4020
Practice Address - Street 1:9843 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:ALTA LOMA
Practice Address - State:CA
Practice Address - Zip Code:91701-5956
Practice Address - Country:US
Practice Address - Phone:909-527-4020
Practice Address - Fax:909-527-4020
Is Sole Proprietor?:No
Enumeration Date:2011-07-31
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433381835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy