Healthcare Provider Details

I. General information

NPI: 1003744194
Provider Name (Legal Business Name): DOLORES MARTIN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9325 CHILDREN'S PLACE
MADERA CA
93636
US

IV. Provider business mailing address

9132 BRECKSVILLE RD
BRECKSVILLE OH
44141-2702
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: