Healthcare Provider Details

I. General information

NPI: 1245728823
Provider Name (Legal Business Name): MARIA GABRIELA MARTUCCI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2018
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 N HARBOR BLVD STE 3100
FULLERTON CA
92835-3825
US

IV. Provider business mailing address

2151 N HARBOR BLVD STE 3100
FULLERTON CA
92835-3825
US

V. Phone/Fax

Practice location:
  • Phone: 530-323-2244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberA203770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: