Active NPI
Carlos Roberto Martinez, I.D.C.
- Independent Duty Corpsman
- Port Hueneme, CA
National Provider Identifier
1689782294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- 161 1St St
BLDG 1402
Port Hueneme, CA 93043-0001 - Phone
- (805) 982-6496
- Fax
- (805) 815-3753
- NPI assigned
- Aug 25, 2006
- Last updated
- Mar 4, 2008
- 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 |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Primary |
Addresses
Primary practice location
161 1St St
BLDG 1402
Port Hueneme, CA 93043-0001
Mailing address
1829B Terrier Street
Point Mugu, CA 93041
Phone (805) 889-5848
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": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1689782294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1829B TERRIER STREET",
"city": "POINT MUGU",
"state": "CA",
"postal_code": "93041",
"telephone_number": "805-889-5848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 1ST ST",
"address_2": "BLDG 1402",
"city": "PORT HUENEME",
"state": "CA",
"postal_code": "930430001",
"telephone_number": "805-982-6496",
"fax_number": "805-815-3753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "CARLOS",
"middle_name": "ROBERTO",
"credential": "I.D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Hueneme, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.