Donovan, Martha Mantilla

Donovan, Martha Mantilla is an sole proprietor health care provider with primary practice located at 2975 Sycamore Dr , Simi Valley CA 93065-1201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Donovan, Martha Mantilla can be contacted via phone (805) 955-6900.

Contact Information

Primary practice address
2975 Sycamore Dr Simi Valley CA 93065-1201
Phone: (805) 955-6900
Fax: (805) 955-6063
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X A53911 California

Profile Details

NPI number 1669496147
LBN Legal business name Donovan, Martha Mantilla
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2006
Last updated Oct 7th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669496147 NPPES
California MEDICAID 00A539112
California Other 00A539110

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