Individual
DR. KEITH L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16671 YORBA LINDA BLVD, SUITE 200, YORBA LINDA, CA 92886-2025
(714) 996-3700
(714) 961-7839
Mailing address
16671 YORBA LINDA BLVD, SUITE 200, YORBA LINDA, CA 92886-2025
(714) 996-3700
(714) 961-7839
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G30724
CA
207RG0100X
Gastroenterology Physician
Primary
G30724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WG30724A
MEDICARE PTAN
CA
05
—
ZZZ82813Z
—
CA
Enumeration date
08/09/2006
Last updated
05/06/2025
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