Individual provider Active NPI

Martin W. Muth, M.D.

  • Obstetrics & Gynecology Physician
  • Long Beach, CA
National Provider Identifier
1306830211
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G25796 Issued in CA
Practice address
3828 Schaufele Ave
Suite 200
Long Beach, CA 90808-1791
Phone
(657) 241-8990
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G25796 CA Primary

Addresses

Primary practice location

3828 Schaufele Ave
Suite 200
Long Beach, CA 90808-1791

Mailing address

17360 Brookhurst St
Attn: Credentialing Dept.
Fountain Valley, CA 92708-3720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110617000382 CA Practitioner - Obstetrics/Gynecology 8820191455 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25796CAMDDentist
G25796CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Obstetrics & Gynecology CurrentSince Oct 26, 2016 Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

2888 Long Beach Blvd
Ste 165
Long Beach, CA 90806
Phone (562) 595-5380

3828 Schaufele Ave
Ste 200
Long Beach, CA 90808
Phone (657) 241-8990

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1306830211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "address_2": "ATTN: CREDENTIALING DEPT.",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 SCHAUFELE AVE",
            "address_2": "SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081791",
            "telephone_number": "657-241-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTH",
        "first_name": "MARTIN",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G25796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.