Healthcare Provider Details

I. General information

NPI: 1841947637
Provider Name (Legal Business Name): FABIAN MARTIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 PAJARO ST STE A
SALINAS CA
93901-3400
US

IV. Provider business mailing address

339 PAJARO ST STE A
SALINAS CA
93901-3400
US

V. Phone/Fax

Practice location:
  • Phone: 831-800-7530
  • Fax: 831-855-1935
Mailing address:
  • Phone: 831-800-7530
  • Fax: 831-855-1935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: