Provider Demographics
NPI:1174043442
Name:GENTILE, CHRISTIAN GABRIEL (AUD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:GABRIEL
Last Name:GENTILE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 VALLEY CHILDREN'S PLACE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636
Mailing Address - Country:US
Mailing Address - Phone:559-353-6801
Mailing Address - Fax:559-353-6950
Practice Address - Street 1:9300 VALLEY CHILDREN'S PLACE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636
Practice Address - Country:US
Practice Address - Phone:559-353-6801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU3192231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist