| Martin J Backman Md Medical Corporation | |
|
11180 Warner Ave Ste 259 Fountain Valley CA 92708-7516 | |
| (714) 540-1840 | |
| (714) 540-2319 |
| Full Name | Martin J Backman Md Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11180 Warner Ave Ste 259, Fountain Valley, California |
| Authorized Official Name and Position | Martin J Backman (OWNER) |
| Authorized Official Contact | 7145401840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin J Backman Md Medical Corporation Po Box 1449 Brea CA 92822-1449 Ph: (714) 996-1633 | Martin J Backman Md Medical Corporation 11180 Warner Ave Ste 259 Fountain Valley CA 92708-7516 Ph: (714) 540-1840 |
| NPI Number | 1275949638 |
|---|---|
| Provider Enumeration Date | 07/07/2014 |
| Last Update Date | 08/13/2025 |
| Certification Date | 08/13/2025 |
| Medicare PECOS PAC ID | 3274751334 |
|---|---|
| Medicare Enrollment ID | O20140924001652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275949638 | NPI | - | NPPES |
| 1699738385 | Other | INDIV NPI | |
| A44638 | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A44638 (California) | Primary |
| Provider Name | Martin J Backman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699738385 PECOS PAC ID: 4789722174 Enrollment ID: I20140924001697 |
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