Provider Demographics
NPI:1700914322
Name:EUFROCINO C. MARTINEZ, M. D., INC.
Entity type:Organization
Organization Name:EUFROCINO C. MARTINEZ, M. D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUFROCINO
Authorized Official - Middle Name:CABOTAJE
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:562-651-0021
Mailing Address - Street 1:12820 STUDEBAKER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2579
Mailing Address - Country:US
Mailing Address - Phone:562-651-0021
Mailing Address - Fax:562-651-1122
Practice Address - Street 1:12820 STUDEBAKER RD STE 100
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2579
Practice Address - Country:US
Practice Address - Phone:562-651-0021
Practice Address - Fax:562-651-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35980208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC35452Medicare UPIN
CAA35980Medicare PIN