Active NPI
Walter Martzen
- Student in an Organized Health Care Education/Training Program
- Monrovia, CA
National Provider Identifier
1205550712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1333 S Mayflower Ave Ste 220
Monrovia, CA 91016-5239 - Phone
- (818) 241-6780
- NPI assigned
- Sep 28, 2022
- Reactivated
- Aug 12, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1333 S Mayflower Ave Ste 220
Monrovia, CA 91016-5239
Mailing address
1486 Huntington Ave Ste 100
South San Francisco, CA 94080-5971
Phone (415) 931-9622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1205550712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1486 HUNTINGTON AVE STE 100",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940805971",
"telephone_number": "415-931-9622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1333 S MAYFLOWER AVE STE 220",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910165239",
"telephone_number": "818-241-6780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTZEN",
"first_name": "WALTER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-28",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"deactivation_date": "2024-08-01",
"reactivation_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monrovia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.