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Organization
MATTHEW W GENTILE OD A PROFESSIONAL OPTOMETRIC CORPORATION
Active
Organization
MATTHEW W GENTILE OD A PROFESSIONAL OPTOMETRIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW WILLIAM GENTILE OD (OWNER)
(858) 450-9400
Entity
Organization
Contact information
Practice address
4150 REGENTS PARK ROW STE 160, LA JOLLA, CA 92037-9138
(858) 450-9400
Mailing address
4150 REGENTS PARK ROW STE 160, LA JOLLA, CA 92037-9138
(858) 450-9400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8079T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8079T
LICENSE NUMBER
CA
Enumeration date
02/12/2018
Last updated
09/12/2025
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