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NPI Code Detail

MEDICARE: DR. LANCE ARNOLD GENTILE M.D.

MEDICARE: DR. LANCE ARNOLD GENTILE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianG35905CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891725438
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LANCE ARNOLD GENTILE M.D.
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-301-8707
Fax Number : 310-301-8751
Provider Business Practice Location Address
First Line : 2424 WILSHIRE BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90403-5806
Country : US
Telephone Number : 310-828-4530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/21/2022

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