Provider Demographics
NPI:1104903178
Name:MARTEL, VIOLETA (MD)
Entity type:Individual
Prefix:DR
First Name:VIOLETA
Middle Name:
Last Name:MARTEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3931 CALGARY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-2504
Mailing Address - Country:US
Mailing Address - Phone:619-956-2960
Mailing Address - Fax:
Practice Address - Street 1:9065 EDGEMOOR DR
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3037
Practice Address - Country:US
Practice Address - Phone:619-956-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB50232Medicare UPIN