MEDICARE: LUIS MARTINEZ M.D.

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
1	207QA0505X	Adult Medicine Physician	A118831	CA

General Provider Information

NPI Number	:	1134423684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS MARTINEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 28949
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-8949
Country	:	US
Telephone Number	:	559-228-5444
Fax Number	:	559-224-3920

Provider Business Practice Location Address
First Line	:	560 E HERNDON AVE # 201
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2907
Country	:	US
Telephone Number	:	559-437-7380
Fax Number	:	559-437-7162

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2010
Last Update Date	:	12/15/2022

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