Provider Demographics
NPI:1700160884
Name:SEMPER MEDICAL CENTER
Entity Type:Organization
Organization Name:SEMPER MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MAXX
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:I
Authorized Official - Credentials:MPAP, PA-C
Authorized Official - Phone:818-653-4299
Mailing Address - Street 1:1750 HUNTINGTON DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2536
Mailing Address - Country:US
Mailing Address - Phone:626-930-1600
Mailing Address - Fax:626-930-1655
Practice Address - Street 1:1750 HUNTINGTON DR
Practice Address - Street 2:SUITE B
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2536
Practice Address - Country:US
Practice Address - Phone:626-930-1600
Practice Address - Fax:626-930-1655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21107261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care