Provider Demographics
NPI:1528681368
Name:MARTINEZ, SHARON ISABELLE (PA)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ISABELLE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:250 N COLLEGE PARK DR APT D21
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-9459
Mailing Address - Country:US
Mailing Address - Phone:240-478-9915
Mailing Address - Fax:
Practice Address - Street 1:5050 SAN BERNARDINO ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2326
Practice Address - Country:US
Practice Address - Phone:909-281-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2022-03-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant