Healthcare Provider Details

I. General information

NPI: 1780524017
Provider Name (Legal Business Name): MS. MARTHA A MCMAHON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ATLANTIC AVE
LONG BEACH CA
90806-1701
US

IV. Provider business mailing address

5826 E HUNTDALE ST
LONG BEACH CA
90808-2718
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-2000
  • Fax:
Mailing address:
  • Phone: 562-716-1370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: