MEDICARE: DR. MARTIN H STAUBER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	G61573	CA

General Provider Information

NPI Number	:	1689742181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN H STAUBER M.D.

Provider Business Mailing Address
First Line	:	16611 YORBA LINDA BLVD
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-2046
Country	:	US
Telephone Number	:	714-528-8670
Fax Number	:	714-528-7315

Provider Business Practice Location Address
First Line	:	16611 YORBA LINDA BLVD
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-2046
Country	:	US
Telephone Number	:	714-528-8670
Fax Number	:	714-528-7315

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	10/26/2007

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