Doctor Name: | DR. KEITH L MARTIN |
NPI Number: | 1649280546 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G30724 |
Business Practice Address: | 16671 Yorba Linda Blvd Suite 200 Yorba Linda, CA - 928862025 |
Business Phone Number: | 7149963700 |
Business Fax Number: | 7149617839 |
Mailing Address: | 16671 Yorba Linda Blvd, Suite 200 YORBA LINDA |
State: | CA |
Postal Code: | 928862025 |
Phone Number: | 7149963700 |
Fax Number: | 7149617839 |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 06/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G30724 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |