Healthcare Provider Details

I. General information

NPI: 1780797837
Provider Name (Legal Business Name): NORMA MARTINEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12522 LAMBERT RD SUITE D
WHITTIER CA
90606
US

IV. Provider business mailing address

5767 W CENTURY BLVD SUITE 200
LOS ANGELES CA
90045-5632
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-0575
  • Fax: 562-945-9756
Mailing address:
  • Phone: 310-828-7172
  • Fax: 310-394-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA74622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: