Provider Demographics
NPI:1972894624
Name:MARTINEZ, LOREN CHRISTOPHER (PA-C)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:CHRISTOPHER
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31565 RANCHO PUEBLO RD STE 201
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4839
Mailing Address - Country:US
Mailing Address - Phone:951-225-7800
Mailing Address - Fax:951-225-7818
Practice Address - Street 1:31565 RANCHO PUEBLO RD STE 201
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4839
Practice Address - Country:US
Practice Address - Phone:951-225-7800
Practice Address - Fax:951-225-7818
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21218363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical