Provider Demographics
NPI:1245209071
Name:MARTIN, JULIA LO (MD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:LO
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:225 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4249
Mailing Address - Country:US
Mailing Address - Phone:760-291-6700
Mailing Address - Fax:
Practice Address - Street 1:225 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4249
Practice Address - Country:US
Practice Address - Phone:760-291-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN35446207Q00000X
CAG144357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN690024100Medicaid
MN01-05405OtherMEDICA
MN080167530OtherRAILROAD MEDICARE
MN151328OtherUCARE MINNESOTA
MN66-04161OtherMEDICA URGENT CARE
MN99F07L0OtherBLUE CROSS
MNNA9141025847OtherPREFERRED ONE
MN1158073OtherAMERICA'S PPO
MN34053100OtherGROUP HEALTH EAU CLAIRE
MNHP10900OtherHEALTH PARTNERS
MNNA9141025847OtherPREFERRED ONE
MNF68386Medicare UPIN