| Doctor Name: | JOSE LUIS SAN MARTIN |
| NPI Number: | 1417275462 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 96471 |
| Business Practice Address: | 18945 Fm 2252 Ste 115 Garden Ridge, TX - 782662797 |
| Business Phone Number: | 2106510029 |
| Business Fax Number: | |
| Mailing Address: | 275 S Worthington St Spc 15, SPRING VALLEY |
| State: | CA |
| Postal Code: | 919776328 |
| Phone Number: | 6194758562 |
| Fax Number: | |
| NPI Enumeration Date: | 05/13/2010 |
| NPI Last Update Date: | 05/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C3402X |
| License Number: | 96471 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Radiography |
| Taxonomy Definition: | |