Provider Demographics
NPI:1245209071
Name:MARTIN, JULIA LO (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:LO
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:28743 VALLEY CENTER RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-6530
Mailing Address - Country:US
Mailing Address - Phone:760-749-0824
Mailing Address - Fax:760-749-2189
Practice Address - Street 1:28743 VALLEY CENTER RD
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-6530
Practice Address - Country:US
Practice Address - Phone:760-749-0824
Practice Address - Fax:760-749-2189
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN35446207Q00000X
CAG144357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN151328OtherUCARE MINNESOTA
MNNA9141025847OtherPREFERRED ONE
MN1158073OtherAMERICA'S PPO
MN66-04161OtherMEDICA URGENT CARE
MNHP10900OtherHEALTH PARTNERS
MN080167530OtherRAILROAD MEDICARE
MN01-05405OtherMEDICA
MN99F07L0OtherBLUE CROSS
MN34053100OtherGROUP HEALTH EAU CLAIRE
MN690024100Medicaid
MNNA9141025847OtherPREFERRED ONE
MNF68386Medicare UPIN