Provider Demographics
NPI:1851454813
Name:MARTINEZ, GILBERTO (MD)
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 MERCY CT STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3154
Mailing Address - Country:US
Mailing Address - Phone:916-967-7285
Mailing Address - Fax:916-967-7289
Practice Address - Street 1:6600 MERCY CT STE 100
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3154
Practice Address - Country:US
Practice Address - Phone:916-967-7285
Practice Address - Fax:916-967-7289
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F69561Medicare UPIN
CA00G746820Medicare PIN