Healthcare Provider Details

I. General information

NPI: 1740200989
Provider Name (Legal Business Name): DANIEL B MARTINEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

854 N HILLVIEW DR
MILPITAS CA
95035-4544
US

IV. Provider business mailing address

854 N HILLVIEW DR
MILPITAS CA
95035-4544
US

V. Phone/Fax

Practice location:
  • Phone: 408-262-5223
  • Fax: 408-262-5011
Mailing address:
  • Phone: 408-262-5223
  • Fax: 408-262-5011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberA32868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: