Individual
MR. BRADY C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
27126 PASEO ESPADA STE 1621, SAN JUAN CAPO, CA 92675-6703
(949) 347-1021
(949) 347-0981
Mailing address
27126 PASEO ESPADA STE 1621, SAN JUAN CAPISTRANO, CA 92675-6703
(949) 347-1021
(949) 347-0981
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
23377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WPT22377C
PPIN
CA
Enumeration date
05/10/2006
Last updated
10/29/2024
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