Provider Demographics
NPI:1104124460
Name:MARTINEZ, HECTOR DANIEL
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:DANIEL
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 RIO GRANDE ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1570
Mailing Address - Country:US
Mailing Address - Phone:626-773-2012
Mailing Address - Fax:
Practice Address - Street 1:932 RIO GRANDE ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104
Practice Address - Country:US
Practice Address - Phone:626-773-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner