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Roy Elias Martinez

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NPI Number Detailed Information

Provider Information:

Name: Roy Elias Martinez
Gender: M
Provider License Number If Given: G56443

NPI Information:

NPI: 1093714511
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 7/1/2008

Provider Business Mailing Address:

Address: 1661 SOQUEL DR BUILDING G
Santa Cruz, CA 95065
Phone Number: 8314761542
Fax Number: 8314648977

Provider Business Practice Location Address:

Address: 1661 SOQUEL DR BUILDING G
Santa Cruz, CA 95065
Phone Number: 8314767711
Fax Number: 8314766189

Provider Taxonomy:

Primary: 2085R0202X
Secondary (if any):
State: CA

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