Most Relevant Information
Provider Data
| NPI Number: | 1003577768 |
| Provider Name: | CRYSTAL MARTIN |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/05/2022 |
| Last Updated: | 06/11/2024 |
Provider Practice Location
661 W 1ST ST STE G
TUSTIN
CA
927802939
Practice Location Phone/Fax
| Phone: | 7146659890 |
| Fax: | 7146659891 |
Provider Mailing Location
661 W 1ST ST STE G
TUSTIN
CA
927802939
Provider Mailing Phone/Fax
| Phone: | 7146659890 |
| Fax: | 7146659891 |