# EVA MARIE GENTILE, MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386903110
- **Authorized official:** EVA MARIE GENTILE MD (CEO)
- **Authorized official phone:** (949) 218-3001

## Contact information

- **Practice address:** 1300 AVENIDA VISTA HERMOSA, 100, SAN CLEMENTE, CA 92673-6315
- **Practice address phone:** (949) 218-3001
- **Practice address fax:** (949) 218-8051
- **Mailing address:** 1300 AVENIDA VISTA HERMOSA, 100, SAN CLEMENTE, CA 92673-6315
- **Mailing address phone:** (949) 218-3001
- **Mailing address fax:** (949) 218-8051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A42926 | CA | Yes |

## Other

- **Enumeration date:** 05/14/2012
- **Last updated:** 05/18/2012