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NPI Code Detail

MEDICARE: DAVID MARTINEZ JR.

MEDICARE: DAVID MARTINEZ JR.
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
1103K00000XBehavior Analyst1-19-34544CA
2106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1659870988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MARTINEZ JR.
Provider Business Mailing Address
First Line : 3415 S SEPULVEDA BLVD STE 1100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-7090
Country : US
Telephone Number : 877-264-6747
Fax Number :
Provider Business Practice Location Address
First Line : 3415 S SEPULVEDA BLVD STE 1100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-7090
Country : US
Telephone Number : 877-264-6747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 10/13/2022

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Directions to “ DAVID MARTINEZ JR. ” Practice Location

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