Provider Demographics
NPI:1215087663
Name:FRANKS, MARTIN LEE (EMT)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:LEE
Last Name:FRANKS
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 695
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93279-0695
Mailing Address - Country:US
Mailing Address - Phone:559-740-0208
Mailing Address - Fax:559-798-0475
Practice Address - Street 1:1844 S MOONEY BLVD
Practice Address - Street 2:0-10
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4455
Practice Address - Country:US
Practice Address - Phone:559-740-0208
Practice Address - Fax:559-798-0475
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAN3591237343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN00879FMedicaid