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General NPI Number Information
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NPI Number | 1871529677
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Entity Type | Individual
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Provider Name | WILLIAM A MARTIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 265 CAMINO AL BARRANCO
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City | LA SELVA BEACH
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State | CA
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Zip | 95076-1505
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Country | US
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Telephone | 831-331-6239
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Fax | 408-342-1972
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Provider Business Mailing Address
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Address Line | 265 CAMINO AL BARRANCO
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City | LA SELVA BEACH
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State | CA
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Zip | 95076-1505
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Country | US
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Telephone | 831-688-2455
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Fax | 408-340-5905
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | G62363
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License Number State | CA
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