Healthcare Provider Details

I. General information

NPI: 1609640630
Provider Name (Legal Business Name): MARTIN SHIANG CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MARTIN MASSAGE THERAPY DBA

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 IRVING ST STE 305
SAN FRANCISCO CA
94122-1763
US

IV. Provider business mailing address

1929 IRVING ST STE 305
SAN FRANCISCO CA
94122-1763
US

V. Phone/Fax

Practice location:
  • Phone: 415-505-4488
  • Fax: 415-566-6677
Mailing address:
  • Phone: 415-505-4488
  • Fax: 415-566-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number95032
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number95032
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: