=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447605407
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARITA SANTIAGO MARTINEZ MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2016
-----------------------------------------------------
Last Update Date | 06/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 N STATE ST ROOM 1018
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90089-1001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-226-6937
-----------------------------------------------------
Fax | 323-226-8101
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21800 AVALON BLVD UNIT 218
-----------------------------------------------------
City | CARSON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90745-3350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-650-9207
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | A142723
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------