# SPORTS MED MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ronica Martinez, MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992825087
- **Authorized official:** DR. RONICA A MARTINEZ M.D. (PRESIDENT)
- **Authorized official phone:** (818) 823-6474

## Contact information

- **Practice address:** 22633 VENTURA BLVD, WOODLAND HILLS, CA 91364-1416
- **Practice address phone:** (818) 444-5100
- **Practice address fax:** (818) 337-7456
- **Mailing address:** PO BOX 4472, GLENDALE, CA 91222-0472
- **Mailing address phone:** (818) 823-6474
- **Mailing address fax:** (818) 337-7456

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A79490 | CA | Yes |

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1861415853 | NPI | CA |