MEDICARE: MRS. NORMA MARTINEZ B.A.

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	225400000X	Rehabilitation Practitioner

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
2	CBSC980	OTHER	CA	LA DMH PROVIDER

General Provider Information

NPI Number	:	1851410815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NORMA MARTINEZ B.A.

Provider Business Mailing Address
First Line	:	237 W GAGE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90003-1436
Country	:	US
Telephone Number	:	213-435-0978
Fax Number	:

Provider Business Practice Location Address
First Line	:	11741 TELEGRAPH RD
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-3681
Country	:	US
Telephone Number	:	562-942-8256
Fax Number	:

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	11/03/2014

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