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NPI Code Detail

MEDICARE: DR. JON V MARTELL MD

MEDICARE:  DR. JON V MARTELL  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD 4898HI

General Provider Information

NPI Number : 1033165469
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JON V MARTELL MD
Provider Business Mailing Address
First Line : PO BOX 998
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91603-0998
Country : US
Telephone Number : 818-509-2222
Fax Number : 818-509-2229
Provider Business Practice Location Address
First Line : 1190 WAIANUENUE AVE
Second Line :
City : HILO
State : HI
Zip : 96720-2020
Country : US
Telephone Number : 808-974-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 07/09/2007

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Directions to “ DR. JON V MARTELL MD” Practice Location

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