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General NPI Number Information
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NPI Number | 1861288573
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Entity Type | Individual
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Provider Name | RAINIER JAMES BRAGANZA MARTIN DO
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Gender | Male
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 2720 SUNSET BLVD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4810
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Country | US
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Telephone | 803-791-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 9191 FLORENCE AVE UNIT 5
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City | DOWNEY
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State | CA
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Zip | 90240-3450
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Country | US
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Telephone | 562-334-7123
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | SC
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