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NPI Code Detail

MEDICARE: CHIRON TRINE

MEDICARE: CHIRON TRINE
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1427618750
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHIRON TRINE
Provider Business Mailing Address
First Line : 1915 BROADVIEW DR
Second Line :
City : GLENDALE
State : CA
Zip : 91208-1201
Country : US
Telephone Number : 818-268-5415
Fax Number :
Provider Business Practice Location Address
First Line : 1915 BROADVIEW DR
Second Line :
City : GLENDALE
State : CA
Zip : 91208-1201
Country : US
Telephone Number : 818-268-5415
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : SARA ZARUI BLIKIAN
Credential :
Telephone Number : 818-268-5415
Provider Enumeration Date : 06/18/2019
Last Update Date : 06/18/2019

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Directions to “CHIRON TRINE ” Practice Location

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