Martin, W Randy
Martin, W Randy is an individual health care provider with primary practice located at 5 Medical Plaza Dr Suite 190, Roseville CA 95661-2865. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Martin, W Randy can be contacted via phone (916) 786-7498.Contact Information
Primary practice address
5 Medical Plaza Dr Suite 190
Roseville CA 95661-2865
Phone: (916) 786-7498
Fax: (916) 786-2715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | G55146 | California |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | G55146 | California |
Profile Details
| NPI number | 1174566566 |
|---|---|
| LBN Legal business name | Martin, W Randy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Feb 28th, 2013 - about 11 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 | 1174566566 | NPPES |
| California | MEDICAID | 00G551460 |
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