Provider Demographics
NPI:1336338300
Name:MARTIN H. KAY, PH. D. MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:MARTIN H. KAY, PH. D. MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PHD
Authorized Official - Phone:818-238-2350
Mailing Address - Street 1:201 S BUENA VISTA ST STE 420
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4571
Mailing Address - Country:US
Mailing Address - Phone:818-238-2350
Mailing Address - Fax:818-238-2351
Practice Address - Street 1:1411 N HOLLYWOOD WAY
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1826
Practice Address - Country:US
Practice Address - Phone:818-238-2350
Practice Address - Fax:818-238-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14437AMedicare PIN