Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | G45660 | CA |
N | 207N00000X | Dermatologist | G45660 | CA |
Y | 207Q00000X | Family Doctor | G45660 | CA |
N | 207QA0401X | Family Doctor - Addiction Medicine | G45660 | CA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | G45660 | CA |
N | 207R00000X | Internist | G45660 | CA |
N | 111NI0900X | Internist | G45660 | CA |
N | 207V00000X | Obstetrician & Gynecologist | G45660 | CA |
N | 208000000X | Pediatrician | G45660 | CA |
N | 208200000X | Surgeon | G45660 | CA |
N | 208600000X | Surgeon | G45660 | CA |
N | 208800000X | Urologist | G45660 | CA |
N | 208C00000X | Colorectal Surgeon | G45660 | CA |
N | 208D00000X | General Practice Physician | G45660 | CA |
NPI | 1578622700 |
---|---|
Provider Name | Dr. Gonzalo Martinez |
First Address | Palmdale, CA 93551-5277 |
Second Address | Palmdale, CA 93551-5277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 20/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A93004 | (02) | CA |