Healthcare Provider Details

I. General information

NPI: 1992911077
Provider Name (Legal Business Name): TRIMICA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6061 ATLANTIC BLVD
MAYWOOD CA
90270-3118
US

IV. Provider business mailing address

6061 ATLANTIC BLVD
MAYWOOD CA
90270-3118
US

V. Phone/Fax

Practice location:
  • Phone: 323-773-3555
  • Fax: 323-773-3444
Mailing address:
  • Phone: 323-773-3555
  • Fax: 323-773-3444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. THOMAS CHAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 323-773-3555