Healthcare Provider Details

I. General information

NPI: 1922137272
Provider Name (Legal Business Name): BELLAFLOR V. TROMPETA, M.D., A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 04/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18433 ROSCOE BLVD STE 104
NORTHRIDGE CA
91325
US

IV. Provider business mailing address

18433 ROSCOE BLVD STE 104
NORTHRIDGE CA
91325
US

V. Phone/Fax

Practice location:
  • Phone: 818-993-9555
  • Fax: 818-993-9558
Mailing address:
  • Phone: 818-993-9555
  • Fax: 818-993-9558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA26147
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA26147
License Number StateCA

VIII. Authorized Official

Name: DR. BELLAFLOR VILLANUEVA TROMPETA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-993-9555