Provider Demographics
NPI:1972372316
Name:MARTIN, JAMES H JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
Last Name:MARTIN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8807 THORNTON RD STE L
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-1863
Mailing Address - Country:US
Mailing Address - Phone:209-271-4228
Mailing Address - Fax:
Practice Address - Street 1:8807 THORNTON RD STE L
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-1863
Practice Address - Country:US
Practice Address - Phone:209-271-4228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75642343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)