Healthcare Provider Details

I. General information

NPI: 1548490238
Provider Name (Legal Business Name): ZACHARIAH W MARTINEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 12/14/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V ST PATIENT SUPPORT SERVICES BLDG, SUITE 1200
SACRAMENTO CA
95817-1460
US

IV. Provider business mailing address

4150 V ST PATIENT SUPPORT SERVICES BLDG, SUITE 1200
SACRAMENTO CA
95817-1460
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5630
  • Fax: 916-734-7980
Mailing address:
  • Phone: 916-734-5630
  • Fax: 916-734-7980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: