Provider Demographics
NPI:1245250992
Name:STRAZNICKY, MARTIN H (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:H
Last Name:STRAZNICKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARTIN
Other - Middle Name:H
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:350 K ST
Mailing Address - Street 2:APARTMENT 406
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6975
Mailing Address - Country:US
Mailing Address - Phone:619-840-0603
Mailing Address - Fax:
Practice Address - Street 1:200 WEST ARBOR DRIVE MC 0801
Practice Address - Street 2:UCSD MEDICAL CENTER
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-0801
Practice Address - Country:US
Practice Address - Phone:619-543-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92410207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A924100Medicaid
CA00A924100Medicaid
CAWA92410AMedicare ID - Type Unspecified
CAWA92410BMedicare ID - Type Unspecified