Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 50260 | CA |
Y | 213EG0000X | General Practice | 50260 | CA |
N | 1223X0400X | Orthodontists | 50260 | CA |
NPI | 1013080902 |
---|---|
Provider Name | Dr. Martha L Gomez |
First Address | Modesto, CA 95355-4228 |
Second Address | Modesto, CA 95355-4228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 05/03/2009 |