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General NPI Number Information
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NPI Number | 1306791389
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Entity Type | Individual
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Provider Name | MICHAEL ADAN ADAM MARTINEZ
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Gender | Male
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 3021 FRANKLIN AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-3337
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Country | US
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Telephone | 951-955-9400
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Fax | 951-679-1234
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Provider Business Mailing Address
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Address Line | 3960 ORANGE ST STE 500
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City | RIVERSIDE
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State | CA
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Zip | 92501-3644
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Country | US
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Telephone | 951-955-9400
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Fax | 951-679-1234
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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 | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number | D8646741
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License Number State | CA
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