Provider Demographics
NPI:1962621409
Name:MARTINET CHIROPRACTIC INC
Entity type:Organization
Organization Name:MARTINET CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN-PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-530-3328
Mailing Address - Street 1:1454 LEIMERT BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1806
Mailing Address - Country:US
Mailing Address - Phone:510-530-3328
Mailing Address - Fax:510-530-2566
Practice Address - Street 1:1454 LEIMERT BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1806
Practice Address - Country:US
Practice Address - Phone:510-530-3328
Practice Address - Fax:510-530-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13352111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04988Medicare UPIN
CADC0133521Medicare ID - Type Unspecified