Provider Demographics
NPI:1992331177
Name:MARTINOFF, LEIF
Entity type:Individual
Prefix:
First Name:LEIF
Middle Name:
Last Name:MARTINOFF
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 1:137 N LARCHMONT BLVD # 626
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-3704
Mailing Address - Country:US
Mailing Address - Phone:310-895-0730
Mailing Address - Fax:
Practice Address - Street 1:3125 BOWL PL
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-3030
Practice Address - Country:US
Practice Address - Phone:310-895-0730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty