Genta, Gordon

Genta, Gordon is an individual health care provider with primary practice located at 2600 E Southern Ave Ste J-2, Tempe AZ 85282-7610. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Genta, Gordon can be contacted via phone (480) 345-0964.

Contact Information

Primary practice address
2600 E Southern Ave Ste J-2 Tempe AZ 85282-7610
Phone: (480) 345-0964
Fax: (480) 820-3309
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 15529 Arizona

Profile Details

NPI number 1922078526
LBN Legal business name Genta, Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922078526 NPPES
Arizona MEDICAID 249880

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