Healthcare Provider Details

I. General information

NPI: 1619126034
Provider Name (Legal Business Name): SHERRI LYNN GENTILE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 09/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

6471 OAKCREST CIR
HUNTINGTON BEACH CA
92648-6126
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2401
  • Fax:
Mailing address:
  • Phone: 714-580-4993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: