Provider Demographics
NPI:1891883393
Name:BICK, MARTIN G (PHD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:G
Last Name:BICK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4000 W METROPOLITAN DR # 401
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3504
Mailing Address - Country:US
Mailing Address - Phone:714-935-6117
Mailing Address - Fax:714-935-6066
Practice Address - Street 1:4000 W METROPOLITAN DR # 401
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3504
Practice Address - Country:US
Practice Address - Phone:714-935-6117
Practice Address - Fax:714-935-6066
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17110103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical