Provider Demographics
NPI:1174529135
Name:RINDAHL, MARTIN ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:ARTHUR
Last Name:RINDAHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1867 E FIR AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3808
Mailing Address - Country:US
Mailing Address - Phone:559-297-0300
Mailing Address - Fax:559-323-5461
Practice Address - Street 1:231 W FIR AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-0220
Practice Address - Country:US
Practice Address - Phone:559-297-0300
Practice Address - Fax:559-323-5461
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG692162085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G692160Medicaid
CA00G692160Medicaid
CA00G692160Medicare ID - Type Unspecified