Provider Demographics
NPI:1447565791
Name:MARTINEZ, ROBERT MAX (MPAP, PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MAX
Last Name:MARTINEZ
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Gender:M
Credentials:MPAP, PA-C
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Mailing Address - Street 1:1750 HUNTINGTON DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2536
Mailing Address - Country:US
Mailing Address - Phone:818-653-4299
Mailing Address - Fax:626-930-1655
Practice Address - Street 1:1750 HUNTINGTON DR
Practice Address - Street 2:SUITE B
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2536
Practice Address - Country:US
Practice Address - Phone:818-653-4299
Practice Address - Fax:626-930-1655
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2021-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA21107363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical