Martin, Keith L

Martin, Keith L is an individual health care provider with primary practice located at 16671 Yorba Linda Blvd Suite 200, Yorba Linda CA 92886-2025. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Martin, Keith L can be contacted via phone (714) 996-3700.

Contact Information

Primary practice address
16671 Yorba Linda Blvd Suite 200 Yorba Linda CA 92886-2025
Phone: (714) 996-3700
Fax: (714) 961-7839
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G30724 California

Profile Details

NPI number 1649280546
LBN Legal business name Martin, Keith L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Jun 27th, 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 1649280546 NPPES
California MEDICAID ZZZ82813Z
California Other WG30724A

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