Healthcare Provider Details

I. General information

NPI: 1285689943
Provider Name (Legal Business Name): SANDRA L MARTIN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 PORTERO AVENUE RM 3A36
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

PO BOX 7464
SAN FRANCISCO CA
94120-7464
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-8811
  • Fax: 415-647-3733
Mailing address:
  • Phone: 415-206-3103
  • Fax: 415-206-3872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE3341
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE3341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: