Individual
DR. KEITH L MARTIN
Active
Individual
DR. KEITH L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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