Provider Demographics
NPI:1760669980
Name:DA MARTO, NATALIE ANNE (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:NATALIE
Middle Name:ANNE
Last Name:DA MARTO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 ORMONDE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-3114
Mailing Address - Country:US
Mailing Address - Phone:650-961-5293
Mailing Address - Fax:
Practice Address - Street 1:540 RALSTON AVE STE B
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-2866
Practice Address - Country:US
Practice Address - Phone:650-363-5668
Practice Address - Fax:650-363-5669
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33214225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050197Medicare PIN