Healthcare Provider Details

I. General information

NPI: 1528479458
Provider Name (Legal Business Name): PRESTON CARLISLE LINSON GENTRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26362 CARMEL RANCHO LN STE 204
CARMEL CA
93923-8858
US

IV. Provider business mailing address

26362 CARMEL RANCHO LN STE 204
CARMEL CA
93923-8858
US

V. Phone/Fax

Practice location:
  • Phone: 831-574-3020
  • Fax: 408-904-6271
Mailing address:
  • Phone: 831-574-3020
  • Fax: 408-904-6271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA158082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: