Healthcare Provider Details

I. General information

NPI: 1295649861
Provider Name (Legal Business Name): GERARDO TREJO LVN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25650 CORBIS ST
MENIFEE CA
92585-8868
US

IV. Provider business mailing address

25650 CORBIS ST
MENIFEE CA
92585-8868
US

V. Phone/Fax

Practice location:
  • Phone: 909-825-7084
  • Fax:
Mailing address:
  • Phone: 909-825-7084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number262189
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: