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General NPI Number Information
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NPI Number | 1982885125
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Entity Type | Organization
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Legal Business Name | DAVID R MARTIN MD, INC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 08/04/2014
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Provider Practice Location 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 | 626-765-6405
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Fax | 626-765-6407
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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 | 626-765-6405
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Fax | 626-765-6407
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID R MARTIN
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Credential | MD
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Telephone | 626-644-3283
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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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