Wansoon Lee Martin, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A51704 Issued in CA

Practice address

10850 Wilshire Blvd
Suite 1150
Los Angeles, CA 90024-4305

Phone

(310) 470-7100

Fax

(310) 470-7110

NPI assigned

Mar 30, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Wanda Leigh Martin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1427178680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 WILSHIRE BLVD",
            "address_2": "SUITE 1150",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244305",
            "telephone_number": "310-470-7100",
            "fax_number": "310-470-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 WILSHIRE BLVD",
            "address_2": "SUITE 1150",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244305",
            "telephone_number": "310-470-7100",
            "fax_number": "310-470-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "WANSOON",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A051704",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A51704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "MARTIN",
            "middle_name": "LEIGH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terrin E Martin, M.D.
• Tharisha Martin
• Tracey Martin, MA, OTRL
• Tyler Martin
• Vannessa Martin
• William Martin
• Yvette Martin, OTD
• Alan Esteban Martines, ASW
• Luis Eduardo Martines, DDS, MSD
• Trevor Joseph Martines

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; 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.