Provider Demographics
NPI:1750450615
Name:KAY, MARTIN H (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:H
Last Name:KAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N HOLLYWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1826
Mailing Address - Country:US
Mailing Address - Phone:818-238-2350
Mailing Address - Fax:818-238-2351
Practice Address - Street 1:1411 N HOLLYWOOD WAY
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1826
Practice Address - Country:US
Practice Address - Phone:818-238-2350
Practice Address - Fax:818-238-2351
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG060115207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A93547Medicare UPIN
CAG060115Medicare ID - Type Unspecified