Basic Information
| Provider Information | |||||||||
| NPI: | 1932374808 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARTIN | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | P O BOX 748157 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900748157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417895250 | ||||||||
| FaxNumber: | 5417895538 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 SW RAMSEY AVE. | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | GRANTS PASS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414796777 | ||||||||
| FaxNumber: | 5414796779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2008 | ||||||||
| LastUpdateDate: | 11/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TL-1790 | CO | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208600000X | DO151685 | OR | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.