MEDICARE: MR. ROBERT MAX MARTINEZ MPAP, PA-C

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	363AM0700X	Medical Physician Assistant	PA21107	CA

General Provider Information

NPI Number	:	1447565791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT MAX MARTINEZ MPAP, PA-C

Provider Business Mailing Address
First Line	:	1750 HUNTINGTON DR
Second Line	:	SUITE B
City	:	DUARTE
State	:	CA
Zip	:	91010-2536
Country	:	US
Telephone Number	:	818-653-4299
Fax Number	:	626-930-1655

Provider Business Practice Location Address
First Line	:	1750 HUNTINGTON DR
Second Line	:	SUITE B
City	:	DUARTE
State	:	CA
Zip	:	91010-2536
Country	:	US
Telephone Number	:	818-653-4299
Fax Number	:	626-930-1655

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

Provider Enumeration Date	:	08/11/2010
Last Update Date	:	11/17/2021

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