Provider Demographics
NPI:1740492180
Name:OFFENBERGER, MARTIN EUGEN (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:EUGEN
Last Name:OFFENBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2700 N MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-6634
Mailing Address - Country:US
Mailing Address - Phone:714-834-1555
Mailing Address - Fax:714-834-0780
Practice Address - Street 1:2700 N MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6634
Practice Address - Country:US
Practice Address - Phone:714-834-1555
Practice Address - Fax:714-834-0780
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85612083X0100X, 208D00000X
HIMD-5271208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB53183Medicare UPIN