MEDICARE: TRINITY ROSE

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
1	261Q00000X	Clinic/Center	L10053	CA

General Provider Information

NPI Number	:	1326914789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINITY ROSE

Provider Business Mailing Address
First Line	:	35325 DATE PALM DR STE 152C
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-7008
Country	:	US
Telephone Number	:	760-442-8856
Fax Number	:	760-442-8856

Provider Business Practice Location Address
First Line	:	35325 DATE PALM DR STE 152C
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-7008
Country	:	US
Telephone Number	:	760-442-8856
Fax Number	:	760-442-8856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	10/14/2025

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Directions to “ TRINITY ROSE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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