Provider Demographics
NPI:1437476421
Name:SCOTT M. MARTIN MD INC
Entity Type:Organization
Organization Name:SCOTT M. MARTIN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-444-1413
Mailing Address - Street 1:5 JOURNEY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5336
Mailing Address - Country:US
Mailing Address - Phone:949-305-7122
Mailing Address - Fax:949-305-7160
Practice Address - Street 1:5 JOURNEY
Practice Address - Street 2:SUITE 220
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-5336
Practice Address - Country:US
Practice Address - Phone:949-305-7122
Practice Address - Fax:949-305-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA941222081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty