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General NPI Number Information
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NPI Number | 1003145848
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Entity Type | Organization
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Legal Business Name | TAMELA MARTIN MD, INC.
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 72301 COUNTRY CLUB DR SUITE 105
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-8007
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Country | US
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Telephone | 760-568-3334
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Fax | 760-568-3335
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Provider Business Mailing Address
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Address Line | 84490 ONDA DR
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City | INDIO
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State | CA
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Zip | 92203-2910
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Country | US
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Telephone | 760-568-3334
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Fax | 760-568-3335
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAMELA A MARTIN
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Credential | MD
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Telephone | 760-568-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G77469
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License Number State | CA
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