Individual
DEOGRACIAS RUFINO MARTINEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2704 N TENAYA WAY, LAS VEGAS, NV 89128-0424
(702) 243-8500
(702) 560-2928
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 243-8500
(702) 560-2928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8869
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679652796
SMA MEDICAID
NV
05
—
GR0021600
—
CA
01
—
V108086
SMA MEDICARE
NV
Enumeration date
11/02/2006
Last updated
09/03/2014
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