MEDICARE: JANICE TRINH

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	363A00000X	Physician Assistant	PA.0008171	CO

General Provider Information

NPI Number	:	1760261507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE TRINH

Provider Business Mailing Address
First Line	:	8585 CRITERION DR # 62094
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 PULSAR DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80916-4503
Country	:	US
Telephone Number	:	719-574-7083
Fax Number	:

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

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	10/05/2023

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Directions to “ JANICE TRINH ” Practice Location

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