Provider Demographics
NPI:1164213252
Name:BUENROSTRO MARTINEZ, LUIS M (MA)
Entity type:Individual
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First Name:LUIS
Middle Name:M
Last Name:BUENROSTRO MARTINEZ
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Gender:M
Credentials:MA
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Mailing Address - Street 1:850 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-5230
Mailing Address - Country:US
Mailing Address - Phone:909-421-9301
Mailing Address - Fax:909-421-9219
Practice Address - Street 1:850 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5230
Practice Address - Country:US
Practice Address - Phone:909-421-9301
Practice Address - Fax:909-421-9219
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant