Provider Demographics
NPI:1336971076
Name:GENTILE, CARLA
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:
Last Name:GENTILE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1758 257TH ST
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-2716
Mailing Address - Country:US
Mailing Address - Phone:310-986-0491
Mailing Address - Fax:
Practice Address - Street 1:1758 257TH ST
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-2716
Practice Address - Country:US
Practice Address - Phone:310-986-0491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula