Individual ProviderMartha GulatiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address127 S San Vicente Blvd Ste A3600, Los Angeles, CA 90048-3311(310) 423-3977PECOS EnrollmentBased on the most recent information from CMS, provider Martha Gulati is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1275523888Provider TypeIndividualFull NameGulati, MarthaTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date10/25/2005Last Updated12/8/2022Contact InformationPractice LocationPractice Address127 S San Vicente Blvd Ste A3600, Los Angeles, CA 90048-3311Phone(310) 423-3977Fax(310) 423-0106Mailing LocationMailing Address4140 W 190th St, Torrance, CA 90504-5513PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RC0000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseC181579CaliforniaCode207RC0000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense35.096301OhioProvider IdentifiersIDDescriptionIssuerID3119048DescriptionMedicaidIssuerUnlistedOhio