Provider Demographics
NPI:1700827052
Name:MARTINEZ CARDENAS, JOSE FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:FRANCISCO
Last Name:MARTINEZ CARDENAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:J OSE
Other - Middle Name:FRANCISCO
Other - Last Name:MARTINEZ CARDENAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:18518 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4212
Mailing Address - Country:US
Mailing Address - Phone:818-757-0954
Mailing Address - Fax:818-757-0963
Practice Address - Street 1:18518 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4212
Practice Address - Country:US
Practice Address - Phone:818-757-0954
Practice Address - Fax:818-757-0963
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 81030207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A810300Medicaid
CAWA81030AMedicare ID - Type UnspecifiedRENDERING PROVIDER NUMBER
CAW16492Medicare ID - Type UnspecifiedMEDICARE GROUP ID NUMBER
CA00A810300Medicaid