Provider Demographics
NPI:1194787093
Name:LEPOW, MARTHA T (MPT)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:T
Last Name:LEPOW
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-2903
Mailing Address - Country:US
Mailing Address - Phone:408-988-1590
Mailing Address - Fax:408-988-1583
Practice Address - Street 1:801 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2903
Practice Address - Country:US
Practice Address - Phone:408-988-1590
Practice Address - Fax:408-988-1583
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT247560Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER