Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A155619 | CA |
NPI | 1093193583 |
---|---|
Provider Name | Dr. Thomas Charles Stratten Martin |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92103-1911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2015 |
Last Update Date | 16/02/2021 |