Provider Demographics
NPI:1578617122
Name:ADVANCED MEDICAL TECHNOLOGY, INC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL TECHNOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROYAL
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:MARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-969-0606
Mailing Address - Street 1:1482 E VALLEY RD
Mailing Address - Street 2:47
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-1200
Mailing Address - Country:US
Mailing Address - Phone:805-969-0606
Mailing Address - Fax:805-969-3630
Practice Address - Street 1:1482 E VALLEY RD
Practice Address - Street 2:47
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-1200
Practice Address - Country:US
Practice Address - Phone:805-969-0606
Practice Address - Fax:805-969-3630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0827690001Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION