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Individual

AMILCARE GENTILI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12519 GREVILLEA PLACE, SAN DIEGO, CA 92160-4896
(216) 255-5700
(216) 255-5701
Mailing address
23625 COMMERCE PARK, SUITE 204, BEACHWOOD, OH 44122
(216) 255-5701
(216) 255-5701

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A44208
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A442080
CA
01
34196095944193
TRICARE WEST
Enumeration date
01/04/2006
Last updated
11/20/2007
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