Organization Active NPI

Enis M Martinez, M. D. a Proffessional Corporation

  • Surgery Physician
  • Hollister, CA
National Provider Identifier
1922215623
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G43931 Issued in CA
Legal business name
ENIS M MARTINEZ, M. D. A PROFFESSIONAL CORPORATION
Practice address
901 Sunset Dr Ste 1
Hollister, CA 95023-5613
Phone
(831) 637-1655
Fax
(831) 637-6894
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Enis M Martinez, M.D.
Title
President
Phone
(831) 637-1655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X G43931 CA Primary

Addresses

Primary practice location

901 Sunset Dr Ste 1
Hollister, CA 95023-5613

Mailing address

901 Sunset Dr Ste 1
Hollister, CA 95023-5613
Phone (831) 637-1655

Other identifiers 1

IdentifierTypeStateIssuer
00G439310MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922215623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SUNSET DR STE 1",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235613",
            "telephone_number": "831-637-1655",
            "fax_number": "831-637-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SUNSET DR STE 1",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235613",
            "telephone_number": "831-637-1655",
            "fax_number": "831-637-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENIS M MARTINEZ, M. D. A PROFFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ENIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-637-1655",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G43931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G439310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.