Epson, Martin Fitzgerald
Epson, Martin Fitzgerald is an individual health care provider with primary practice located at 240 Tamal Vista Blvd #160, Corte Madera CA 94925. He recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Forensic Psychiatry, Allopathic & Osteopathic Physicians / Psychosomatic Medicine. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Epson, Martin Fitzgerald can be contacted via phone (415) 473-2100.Contact Information
Primary practice address
240 Tamal Vista Blvd #160
Corte Madera CA 94925
Phone: (415) 473-2100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | MD29256 | Oregon |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | DR.0051514 | Colorado |
| Allopathic & Osteopathic Physicians / Addiction Psychiatry | 2084P0802X | 132723 | California |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 132723 | California |
| Allopathic & Osteopathic Physicians / Forensic Psychiatry | 2084F0202X | 132723 | California |
| Allopathic & Osteopathic Physicians / Psychosomatic Medicine | 2084P0015X | 132723 | California |
Profile Details
| NPI number | 1801098967 |
|---|---|
| LBN Legal business name | Epson, Martin Fitzgerald |
| Credentials | M.D., J.D., M.T.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2007 |
| Last updated | Jun 16th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801098967 | NPPES |
| Colorado | MEDICAID | 21956260 |
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