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Organization

SPORTS MED MD, INC

Active
Other names
Ronica Martinez, MD
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RONICA A MARTINEZ M.D. (PRESIDENT)
(818) 823-6474
Entity
Organization

Contact information

Practice address
22633 VENTURA BLVD, WOODLAND HILLS, CA 91364-1416
(818) 444-5100
(818) 337-7456
Mailing address
PO BOX 4472, GLENDALE, CA 91222-0472
(818) 823-6474
(818) 337-7456

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A79490
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1861415853
NPI
CA
Enumeration date
03/30/2007
Last updated
08/22/2020
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