Healthcare Provider Details

I. General information

NPI: 1326597162
Provider Name (Legal Business Name): PETER TRIMBOLI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 W SUMMER HAVEN LN
LAKESIDE AZ
85929-7082
US

IV. Provider business mailing address

723 W SUMMER HAVEN LN
LAKESIDE AZ
85929-7082
US

V. Phone/Fax

Practice location:
  • Phone: 480-868-9587
  • Fax: 480-868-9587
Mailing address:
  • Phone: 480-868-9587
  • Fax: 480-868-9587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAS-0557
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: