Centerville Medical Group and Associates, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CENTERVILLE MEDICAL GROUP AND ASSOCIATES, INC.

Practice address

3778 Bonde Way
Fremont, CA 94536-3646

Phone

(510) 818-9100

Fax

(510) 818-9901

NPI assigned

Oct 18, 2006

Organization subpart

No

Name

Dr. Lene V.M. Martinez, M.D.NPI 1396748059

Title

President

Phone

(510) 818-9100

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lene Vidola Mission Martinez, M.D.

  • Specialist
  • Brawley, CA
  • NPI 1396748059
  NPD (past) Authorized official
• Emmanuel Dela Cruz Cepe, MD

  • Family Medicine Physician
  • Napa, CA
  • NPI 1063526812
  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013098532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3778 BONDE WAY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945363646",
            "telephone_number": "510-818-9100",
            "fax_number": "510-818-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3778 BONDE WAY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945363646",
            "telephone_number": "510-818-9100",
            "fax_number": "510-818-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE MEDICAL GROUP AND ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LENE",
        "authorized_official_middle_name": "V.M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-818-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fremont, CA
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.