Healthcare Provider Details

I. General information

NPI: 1568780211
Provider Name (Legal Business Name): TRINITY THREE COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 N ALAMEDA ST SUITE A
COMPTON CA
90222-1406
US

IV. Provider business mailing address

3209 N ALAMEDA ST SUITE A
COMPTON CA
90222-1406
US

V. Phone/Fax

Practice location:
  • Phone: 310-638-1102
  • Fax: 888-552-5793
Mailing address:
  • Phone: 310-638-1102
  • Fax: 888-552-5793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number10113
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateCA

VIII. Authorized Official

Name: LATRICE POLK
Title or Position: MANAGER
Credential:
Phone: 310-638-1102