MEDICARE: ELENA MARTINHO MD

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	207N00000X	Dermatology Physician	G65112	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	070004201	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710987888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA MARTINHO MD

Provider Business Mailing Address
First Line	:	1111 LAS TABLAS RD
Second Line	:	STE 0
City	:	TEMPLETON
State	:	CA
Zip	:	93465-9732
Country	:	US
Telephone Number	:	805-434-1511
Fax Number	:	805-434-3441

Provider Business Practice Location Address
First Line	:	1111 LAS TABLAS RD
Second Line	:	STE 0
City	:	TEMPLETON
State	:	CA
Zip	:	93465-9732
Country	:	US
Telephone Number	:	805-434-1511
Fax Number	:	805-434-3441

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	11/17/2008

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Directions to “ ELENA MARTINHO MD” Practice Location

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