| Doctor Name: | MARTIN MADRIGAL |
| NPI Number: | 1043371636 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA17142 |
| Business Practice Address: | 5404 Moreno St Suite N Montclair, CA - 917631667 |
| Business Phone Number: | 9099494400 |
| Business Fax Number: | 9099494441 |
| Mailing Address: | 5404 Moreno St, Suite N MONTCLAIR |
| State: | CA |
| Postal Code: | 917631667 |
| Phone Number: | 9099494400 |
| Fax Number: | 9099494441 |
| NPI Enumeration Date: | 12/13/2006 |
| NPI Last Update Date: | 12/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA17142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |