Provider Demographics
NPI:1780797837
Name:MARTINEZ, NORMA (MD)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5632
Mailing Address - Country:US
Mailing Address - Phone:310-828-7172
Mailing Address - Fax:310-394-7807
Practice Address - Street 1:12522 LAMBERT RD
Practice Address - Street 2:SUITE D
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606
Practice Address - Country:US
Practice Address - Phone:562-698-0575
Practice Address - Fax:562-945-9756
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2010-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA74622207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A746220Medicaid
CAWA74622BMedicare PIN
CAWA74622AMedicare PIN
CA00A746220Medicaid