Individual
MR. MIKE T MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CO
Contact information
Practice address
1848 FULTON AVE, SACRAMENTO, CA 95825-1925
(916) 488-1478
(916) 488-1807
Mailing address
1848 FULTON AVE, SACRAMENTO, CA 95825-1925
(916) 488-1478
(916) 488-1807
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
CO2798
CA
222Z00000X
Orthotist
Primary
CO2798
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0152576
KAISER
CA
01
—
C00027980
BC
CA
05
—
XA0027980
—
CA
Enumeration date
03/13/2008
Last updated
07/25/2008
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