Individual
EDGAR IVAN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3445 PACIFIC COAST HWY STE 110, TORRANCE, CA 90505-6659
(310) 325-4555
Mailing address
PO BOX 3129, TORRANCE, CA 90510-3129
(310) 792-3914
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
K6128
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038297003
—
TX
01
—
8U3369
BLUE CROSS ID
TX
Enumeration date
11/08/2006
Last updated
09/22/2021
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