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Physician Compare National (NPI:1356528434)

HEALTHCARE PROVIDER: MICHEL MARTIR LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1356528434
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 8820330640
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20190426001996
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MARTIR
Individual professional last name
Provider First Name MICHEL
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2011
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 224 LANDIS AVE
Group Practice or individual's line 1 address
City CHULA VISTA
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 919102609
Group Practice or individual's zip code (9 digits when available)
Phone Number 6194193940
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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