Basic Information
| Provider Information | |||||||||
| NPI: | 1326206335 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRISON | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11406 LOMA LINDA DR | ||||||||
| Address2: | SUITE 218 | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923543711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095586444 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 25455 BARTON RD | ||||||||
| Address2: | SUITE 102B | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923543128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095582808 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2008 | ||||||||
| LastUpdateDate: | 01/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XP3100X | MT190572 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Pediatric Orthopaedic Surgery | 207X00000X | MT190572 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | MD208281 | OR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.