Provider Demographics
NPI:1649304650
Name:MARTINEZ, CARLOS TOMAS JORGE (DO)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:TOMAS JORGE
Last Name:MARTINEZ
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Gender:M
Credentials:DO
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Mailing Address - Street 1:7777 MILLIKEN AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6780
Mailing Address - Country:US
Mailing Address - Phone:909-944-3797
Mailing Address - Fax:909-944-3914
Practice Address - Street 1:7777 MILLIKEN AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6780
Practice Address - Country:US
Practice Address - Phone:909-944-3797
Practice Address - Fax:909-944-3914
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2011-07-18
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Provider Licenses
StateLicense IDTaxonomies
CA20A98562081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
20A9856Medicare PIN