| Eva Marie Gentile, Md Inc | |
|
1300 Avenida Vista Hermosa 100 San Clemente CA 92673-6315 | |
| (949) 218-3001 | |
| (949) 218-8051 |
| Full Name | Eva Marie Gentile, Md Inc |
|---|---|
| Speciality | General Practice |
| Location | 1300 Avenida Vista Hermosa, San Clemente, California |
| Authorized Official Name and Position | Eva Marie Gentile (CEO) |
| Authorized Official Contact | 9492183001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eva Marie Gentile, Md Inc 1300 Avenida Vista Hermosa 100 San Clemente CA 92673-6315 Ph: (949) 218-3001 | Eva Marie Gentile, Md Inc 1300 Avenida Vista Hermosa 100 San Clemente CA 92673-6315 Ph: (949) 218-3001 |
| NPI Number | 1386903110 |
|---|---|
| Provider Enumeration Date | 05/14/2012 |
| Last Update Date | 05/18/2012 |
| Medicare PECOS PAC ID | 8426211491 |
|---|---|
| Medicare Enrollment ID | O20120601000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386903110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A42926 (California) | Primary |
| Provider Name | Eva M Gentile |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811030117 PECOS PAC ID: 1355255423 Enrollment ID: I20031113000796 |
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