Individual
WAYNE HAMILTON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 GRAND AVE, SUITE A, DIAMOND BAR, CA 91765-4171
(909) 860-6768
(909) 860-4224
Mailing address
1111 GRAND AVE, SUITE A, DIAMOND BAR, CA 91765-4171
(909) 860-6768
(909) 860-4224
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G56034
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G560342
—
CA
Enumeration date
10/24/2006
Last updated
10/09/2009
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