Martinez, Walter Ivan
Martinez, Walter Ivan is an individual health care provider with primary practice located at 11843 Gilmore St Apt 210 , North Hollywood CA 91606-2857. He recently has only one registered license in Dental Providers / Dental Assistant, which is considered as his primary health care specialty. Martinez, Walter Ivan can be contacted via phone (818) 818-7362.Contact Information
Primary practice address
11843 Gilmore St Apt 210
North Hollywood CA 91606-2857
Phone: (818) 818-7362
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Assistant | 126800000X | 86972 | California |
Profile Details
| NPI number | 1902418734 |
|---|---|
| LBN Legal business name | Martinez, Walter Ivan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 21st, 2020 |
| Last updated | Aug 21st, 2020 - about 5 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 | 1902418734 | NPPES |
| California | MEDICAID | 86972 |
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