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General NPI Number Information
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NPI Number | 1770878795
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Entity Type | Individual
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Provider Name | MARTIN DENN PSYD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2011
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Last Update Date | 06/17/2011
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Provider Practice Location Address
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Address Line | 738 33RD ST
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-3455
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Country | US
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Telephone | 310-545-9412
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Fax | 310-545-6339
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Provider Business Mailing Address
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Address Line | 738 33RD ST
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-3455
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Country | US
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Telephone | 310-874-9493
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Fax | 310-545-6339
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PYS23480
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License Number State | CA
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