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General NPI Number Information
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NPI Number | 1720037807
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Entity Type | Individual
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Provider Name | DAVID R MARTIN MD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 955 S ARROYO PKWY 3RD FLOOR
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City | PASADENA
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State | CA
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Zip | 91105
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Country | US
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Telephone | 626-644-3283
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Fax | 626-683-8331
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Provider Business Mailing Address
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Address Line | 950 S ARROYO PKWY 3RD FLOOR SUITE
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City | PASADENA
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State | CA
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Zip | 91105-3930
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Country | US
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Telephone | 626-644-3283
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Fax | 626-683-8331
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A62108
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License Number State | CA
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