Individual
EMILY RUTHANNE GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
39141 CIVIC CENTER DR STE 335, FREMONT, CA 94538-5878
(510) 248-1450
(510) 742-8244
Mailing address
39141 CIVIC CENTER DR STE 335, FREMONT, CA 94538-5878
(510) 248-1450
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60937
CA
363AS0400X
Surgical Physician Assistant
Primary
PA60937
CA
Other
Enumeration date
10/22/2021
Last updated
03/29/2022
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