Individual
MATTHEW JOSEPH GENTILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NAVY IDC
Contact information
Practice address
442 FLORENCIA LN, VISTA, CA 92083-4810
(949) 466-2013
Mailing address
442 FLORENCIA LN, VISTA, CA 92083-4810
(949) 466-2013
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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