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NPI Code Detail

MEDICARE: DR. KEVIN EARL MARTIN

MEDICARE: DR. KEVIN EARL MARTIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor16720CA

General Provider Information

NPI Number : 1225162142
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN EARL MARTIN
Provider Business Mailing Address
First Line : 2513 COLORADO BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90041-1004
Country : US
Telephone Number : 323-254-0917
Fax Number : 323-254-6411
Provider Business Practice Location Address
First Line : 2513 COLORADO BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90041-1004
Country : US
Telephone Number : 323-254-0917
Fax Number : 323-254-6411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 08/24/2012

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Directions to “ DR. KEVIN EARL MARTIN ” Practice Location

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