Provider Demographics
NPI:1720084049
Name:BRESS, MARTIN M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:M
Last Name:BRESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:930 SUNNYSLOPE RD.
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5616
Mailing Address - Country:US
Mailing Address - Phone:831-637-9215
Mailing Address - Fax:831-637-8765
Practice Address - Street 1:930 SUNNYSLOPE RD
Practice Address - Street 2:STE B1
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5616
Practice Address - Country:US
Practice Address - Phone:831-637-9215
Practice Address - Fax:831-637-8765
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24462207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42271Medicare UPIN