MEDICARE: MEGAN MARTZ

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
1	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian	86118015	CA

General Provider Information

NPI Number	:	1376322032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MARTZ

Provider Business Mailing Address
First Line	:	3535 ELY AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-3309
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2572 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2751
Country	:	US
Telephone Number	:	562-296-2265
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2023
Last Update Date	:	09/22/2023

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Directions to “ MEGAN MARTZ ” Practice Location

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