MEDICARE: DR. MARTHA GULATI MD

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	207RC0000X	Cardiovascular Disease Physician	35.096301	OH
2	207RC0000X	Cardiovascular Disease Physician	C181579	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275523888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTHA GULATI MD

Provider Business Mailing Address
First Line	:	4140 W 190TH ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-5513
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	127 S SAN VICENTE BLVD STE A3600
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-3311
Country	:	US
Telephone Number	:	310-423-3977
Fax Number	:	310-423-0106

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	12/08/2022

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Directions to “ DR. MARTHA GULATI MD” Practice Location

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