Healthcare Provider Details

I. General information

NPI: 1619900503
Provider Name (Legal Business Name): MICHAEL RAYMOND MARTINES DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710 N WEST AVE STE 101
FRESNO CA
93711-4300
US

IV. Provider business mailing address

2285 W.SAN MADELE
FRESNO CA
93711-1396
US

V. Phone/Fax

Practice location:
  • Phone: 559-709-7801
  • Fax:
Mailing address:
  • Phone: 559-433-1256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number32422
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number32422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: