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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 |
