MEDICARE: MARTHAPAOLA MARTINEZ

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	376K00000X	Nurse's Aide		CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1538840889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHAPAOLA MARTINEZ

Provider Business Mailing Address
First Line	:	115 DOLORES ST APT 5
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-5521
Country	:	US
Telephone Number	:	619-289-3543
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 DOLORES ST APT 5
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-5521
Country	:	US
Telephone Number	:	619-289-3543
Fax Number	:

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

Provider Enumeration Date	:	07/28/2023
Last Update Date	:	07/28/2023

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Directions to “ MARTHAPAOLA MARTINEZ ” Practice Location

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