Individual
MIKEL CLIFFORD GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5241 PALOMA RD, RIVERSIDE, CA 92509-2247
(209) 718-3453
Mailing address
5241 PALOMA RD, RIVERSIDE, CA 92509-2247
(209) 718-3453
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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