Provider Demographics
NPI:1942496617
Name:GENTINI, RAUL A (MD)
Entity Type:Individual
Prefix:
First Name:RAUL
Middle Name:A
Last Name:GENTINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27206 CALAROGA AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4300
Mailing Address - Country:US
Mailing Address - Phone:510-887-4711
Mailing Address - Fax:510-887-2470
Practice Address - Street 1:27206 CALAROGA AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4300
Practice Address - Country:US
Practice Address - Phone:510-887-4711
Practice Address - Fax:510-887-2470
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA110785207Q00000X
WAMD00048829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine