Healthcare Provider Details

I. General information

NPI: 1174436919
Provider Name (Legal Business Name): CEDRICK L MARTIN RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14500 MCNAB AVE APT 610
BELLFLOWER CA
90706-3337
US

IV. Provider business mailing address

14500 MCNAB AVE APT 610
BELLFLOWER CA
90706-3337
US

V. Phone/Fax

Practice location:
  • Phone: 657-251-6565
  • Fax:
Mailing address:
  • Phone: 657-251-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number47658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: