Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | C130503 | CA |
NPI | 1053554550 |
---|---|
Provider Name | Dr. Timothy Paul Martens |
First Address | Loma Linda, CA 92350-1700 |
Second Address | Loma Linda, CA 92354-2804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 19/12/2017 |