| Justin Martinez, CRNA | |
|
9961 Sierra Ave, Fontana, CA 92335-6720 | |
| (909) 302-4886 | |
| Not Available |
| Full Name | Justin Martinez |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 9961 Sierra Ave, Fontana, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477022051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 95000981 (California) | Primary |
| Entity Name | Faculty Physicians And Surgeons Of Llusm |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
| Entity Name | Pacific Valley Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851312862 PECOS PAC ID: 3577465368 Enrollment ID: O20040122000762 |
| Mailing Address | Practice Location Address |
|---|---|
| Justin Martinez, CRNA 1884 Forest Dr, Azusa, CA 91702-6242 Ph: (626) 485-8365 | Justin Martinez, CRNA 9961 Sierra Ave, Fontana, CA 92335-6720 Ph: (909) 302-4886 |
Kadette Kelly, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Kenneth B Lake, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Ronald D Stephens, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Alyssa Miller, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 000-000-0000 | |
Brendan Williams, DNP, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 15218 Summit Ave Ste 300-130, Fontana, CA 92336 Phone: 909-255-2661 | |
Hisham Maassarani, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-302-4886 | |
Edith M Marca-solomon, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 |