Healthcare Provider Details

I. General information

NPI: 1558725572
Provider Name (Legal Business Name): DEBORAH BRUNO MARTINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 CADILLAC AVE MEDICAL OFFICES BUILDING, 1ST FLOOR, DEPARTMENT 156
LOS ANGELES CA
90034
US

IV. Provider business mailing address

6041 CADILLAC AVE MEDICAL OFFICES BUILDING, 1ST FLOOR, DEPARTMENT 156
LOS ANGELES CA
90034
US

V. Phone/Fax

Practice location:
  • Phone: 323-857-2758
  • Fax:
Mailing address:
  • Phone: 323-857-2758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA152842
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberA152842
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: