Provider Demographics
NPI:1740327048
Name:MARTEN, TIMOTHY J (MD FACS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:MARTEN
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Gender:M
Credentials:MD FACS
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Mailing Address - Street 1:450 SUTTER ST
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4206
Mailing Address - Country:US
Mailing Address - Phone:415-677-9937
Mailing Address - Fax:415-677-9473
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:SUITE 2222
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4206
Practice Address - Country:US
Practice Address - Phone:415-677-9937
Practice Address - Fax:415-677-9473
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG52421208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGMD045789Medicare UPIN