Healthcare Provider Details

I. General information

NPI: 1962724153
Provider Name (Legal Business Name): KEVIN TRINH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HAI TRINH

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 DUBLIN BLVD
DUBLIN CA
94568-3113
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 510-498-2376
  • Fax:
Mailing address:
  • Phone: 510-498-2376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number142866
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA142866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: