Provider Demographics
NPI:1053876284
Name:EVANGELINA E MARTINEZ MD INC
Entity type:Organization
Organization Name:EVANGELINA E MARTINEZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATRINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-375-6334
Mailing Address - Street 1:2 UPPER RAGSDALE DR STE B200
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7844
Mailing Address - Country:US
Mailing Address - Phone:831-375-6334
Mailing Address - Fax:831-375-6331
Practice Address - Street 1:2 UPPER RAGSDALE DR STE B200
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7844
Practice Address - Country:US
Practice Address - Phone:831-375-6334
Practice Address - Fax:831-375-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty