Provider Demographics
NPI:1063539435
Name:MARTINEZ, GERALYN (NP)
Entity type:Individual
Prefix:MS
First Name:GERALYN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE # 1E21
Mailing Address - Street 2:EMERGENCY MEDICINE NURSING
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-8111
Mailing Address - Fax:415-206-5818
Practice Address - Street 1:1001 POTRERO AVE # 1E21
Practice Address - Street 2:EMERGENCY MEDICINE NURSING
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8111
Practice Address - Fax:415-206-5818
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN231018163WE0003X
CANPF9107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WE0003XNursing Service ProvidersRegistered NurseEmergency
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
011650OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
S19084Medicare UPIN