NPIMap

Organization Active NPI

Jeannette Martello MD a Professional Corporation

Doing business as Skin Deep

  • Medical Specialty Clinic/Center
  • South Pasadena, CA
National Provider Identifier
1497992465
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
G066298 Issued in CA
Legal business name
JEANNETTE MARTELLO MD A PROFESSIONAL CORPORATION
Doing business as
Skin Deep
Practice address
701 Fremont Ave
South Pasadena, CA 91030-2529
Phone
(626) 403-1747
Fax
(626) 403-1784
NPI assigned
Jan 13, 2009
Last updated
Feb 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Authorized official

Name
Dr. Jeannette Yvette Martello, M.D.NPI 1245452424
Title
President
Phone
(626) 403-1747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X G066298 CA Primary

Addresses

Primary practice location

701 Fremont Ave
South Pasadena, CA 91030-2529

Mailing address

701 Fremont Ave
South Pasadena, CA 91030-2529
Phone (626) 403-1747

Other identifiers 1

IdentifierTypeStateIssuer
1245452424OtherCAINDIVIDUAL PROVIDER NPI

Other names 1

  • Skin Deep Doing business as

National Provider Directory

National Provider Directory

Locations

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1497992465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 FREMONT AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302529",
            "telephone_number": "626-403-1747",
            "fax_number": "626-403-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 FREMONT AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302529",
            "telephone_number": "626-403-1747",
            "fax_number": "626-403-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNETTE MARTELLO MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "MARTELLO",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-403-1747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G066298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI",
            "identifier": "1245452424",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skin Deep",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.