Martha Mantilla Donovan, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A53911 Issued in CA

Practice address

2975 Sycamore Dr
Simi Valley, CA 93065-1201

Phone

(805) 955-6900

Fax

(805) 955-6063

NPI assigned

Jul 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kanakavalli Suresh Iyer, M.D., Inc.

  • Anesthesiology Physician
  • Simi Valley, CA
  • NPI 1700250578
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1669496147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60790",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911166790",
            "telephone_number": "626-795-6596",
            "fax_number": "626-795-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 SYCAMORE DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651201",
            "telephone_number": "805-955-6900",
            "fax_number": "805-955-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "MARTHA",
        "middle_name": "MANTILLA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A53911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A539112",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A539110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Doettrel
• Ephraim Dolz, PTA
• Monique Dominguez
• Leigh Michael Donart, LPT
• Dong Le, OD, Inc.
• Anna Michelle Dorch, RN, BSN, PHN
• Donald Gratton Downs, MD.
• Dr Carrie R Kubota & Associates
• Dr. Dantae D Davies MD
• Dr. Porter Sports Chiropractic & Wellness Inc.

• Anesthesiology Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.