Healthcare Provider Details

I. General information

NPI: 1437845492
Provider Name (Legal Business Name): ROMAN MARTINEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 MERCY CT STE 100
FAIR OAKS CA
95628-3154
US

IV. Provider business mailing address

6600 MERCY CT
FAIR OAKS CA
95628-3158
US

V. Phone/Fax

Practice location:
  • Phone: 916-967-7285
  • Fax: 916-967-7289
Mailing address:
  • Phone: 916-967-7285
  • Fax: 916-967-7289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA198568
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: