Provider Demographics
NPI:1124038005
Name:MARTINEZ, ROLANDO A (DC)
Entity Type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 NUTMEG PL
Mailing Address - Street 2:SUITE110
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-2501
Mailing Address - Country:US
Mailing Address - Phone:714-437-9763
Mailing Address - Fax:714-437-9764
Practice Address - Street 1:1520 NUTMEG PL
Practice Address - Street 2:SUITE110
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-2501
Practice Address - Country:US
Practice Address - Phone:714-437-9763
Practice Address - Fax:714-437-9764
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor