MEDICARE: DR. RON R MARTIN D.C.

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	111N00000X	Chiropractor	DC22073	CA

General Provider Information

NPI Number	:	1699878967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RON R MARTIN D.C.

Provider Business Mailing Address
First Line	:	1216 SUNCAST LN
Second Line	:	SUITE 2
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9668
Country	:	US
Telephone Number	:	916-933-8100
Fax Number	:	916-933-7356

Provider Business Practice Location Address
First Line	:	1216 SUNCAST LN
Second Line	:	SUITE2
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9668
Country	:	US
Telephone Number	:	916-933-8100
Fax Number	:	916-933-7356

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

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	05/21/2009

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