Provider Demographics
NPI:1487260758
Name:MARTIN, JULIAN
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:MARTIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 PARK COURT PL BLDG H
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-5028
Mailing Address - Country:US
Mailing Address - Phone:714-881-8601
Mailing Address - Fax:
Practice Address - Street 1:1801 PARK COURT PL BLDG H
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-5028
Practice Address - Country:US
Practice Address - Phone:714-881-8601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CA247000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information