Provider Demographics
NPI:1790915882
Name:MARTINEZ, KAREN PATRICIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:PATRICIA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1034 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2449
Mailing Address - Country:US
Mailing Address - Phone:626-256-3638
Mailing Address - Fax:626-256-4168
Practice Address - Street 1:1034 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2449
Practice Address - Country:US
Practice Address - Phone:626-256-3638
Practice Address - Fax:626-256-4168
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20414363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical