Provider Demographics
NPI:1386783652
Name:MARTINEZ, JOSEPH ALMONTE
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALMONTE
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 1:2028 E ROUTE 66
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4609
Mailing Address - Country:US
Mailing Address - Phone:626-957-0245
Mailing Address - Fax:626-857-0495
Practice Address - Street 1:2028 E ROUTE 66
Practice Address - Street 2:SUITE 104
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4609
Practice Address - Country:US
Practice Address - Phone:626-957-0245
Practice Address - Fax:626-857-0495
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103603332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4014160001Medicare NSC