Provider Demographics
NPI:1992979157
Name:JORGE A. MARTINEZ, M.D., A MEDICAL CORPORATION
Entity type:Organization
Organization Name:JORGE A. MARTINEZ, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-461-1331
Mailing Address - Street 1:39755 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:STE E120
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9151
Mailing Address - Country:US
Mailing Address - Phone:951-461-1331
Mailing Address - Fax:951-461-1307
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE E120
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9115
Practice Address - Country:US
Practice Address - Phone:951-461-1307
Practice Address - Fax:951-461-1307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A491131Medicaid
1992748883OtherNPI
1992748883OtherNPI
CAE52442Medicare UPIN