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General NPI Number Information
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NPI Number | 1124161120
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Entity Type | Individual
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Provider Name | WILLIAM A MARTINEZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2033 W 7TH ST SUITE 3
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City | LOS ANGELES
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State | CA
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Zip | 90057-4073
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Country | US
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Telephone | 213-484-2288
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Fax | 213-484-2225
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Provider Business Mailing Address
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Address Line | 2033 W 7TH ST SUITE3
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City | LOS ANGELES
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State | CA
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Zip | 90057-4073
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Country | US
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Telephone | 213-484-2288
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Fax | 213-484-2225
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA15129
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License Number State | CA
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