Provider Information

Last Updated : Aug 14 2024 4:02 PM

Martin Martin




City
Clovis
Group
HEALTH NET DIRECT FFS MEDI-CAL
Specialty
Qualified Autism Svc Provider
Last Name
Martin
First Name
Martin
Address
2261 Villa Ave
State
CA
Zip Code
93612
Phone
(559)575-8172
Hours
Mon - Thu 8:00 AM - 5:00 PM Fri 9:00 AM - 2:00 PM
Gender
M
Title
MSP
Physician ID
909087
Section Number
A
County
FRESNO
Accepting New Patient
Yes
PPG NAME
HEALTH NET DIRECT FFS MEDI-CAL
PPG ID
MHDML
NPI Number
1588159909
Access Requirement
Limited
PARKING_IND
P
EXT_BUILD_IND
EB
INT_BUILD_IND
IB
RESTROOM_IND
R
License ID
BCB52077
Email
credentialing@plutushealthinc.com
Board Certified
No
Self Access Flag
Self Reported Data

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