Organization
LOS ANGELES UROLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL MARTINEZ M.D, (PRESIDENT)
(323) 261-0108
Entity
Organization
Contact information
Practice address
1701 E CESAR E CHAVEZ AVE, SUITE 500, LOS ANGELES, CA 90033-2464
(323) 261-0108
(323) 224-6206
Mailing address
1701 E CESAR E CHAVEZ AVE, SUITE 500, LOS ANGELES, CA 90033-2464
(323) 261-0108
(323) 224-6206
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G54840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0063220
—
CA
Enumeration date
01/18/2007
Last updated
04/26/2024
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