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NPI Code Detail

MEDICARE: DR JEREMY MARTINEZ MD A PROFESSIONAL CORPORATION

MEDICARE: DR JEREMY MARTINEZ MD A PROFESSIONAL CORPORATION
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
1261QM0850XAdult Mental Health Clinic/CenterA101936CA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
32084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1770947525
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR JEREMY MARTINEZ MD A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 8605 SANTA MONICA BLVD PMB 28031
Second Line :
City : WEST HOLLYWOOD
State : CA
Zip : 90069-4109
Country : US
Telephone Number : 424-240-8511
Fax Number : 866-569-5017
Provider Business Practice Location Address
First Line : 21515 HAWTHORNE BLVD STE 200
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6512
Country : US
Telephone Number : 424-240-8511
Fax Number : 866-569-5017
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. JEREMY DAVID MARTINEZ
Credential :
Telephone Number : 424-240-8511
Provider Enumeration Date : 04/07/2016
Last Update Date : 01/26/2026

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