Healthcare Provider Details

I. General information

NPI: 1073400651
Provider Name (Legal Business Name): TRIDENT MEDICAL EVALUATORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1198 PACIFIC COAST HWY STE D #519
SEAL BEACH CA
90740-6200
US

IV. Provider business mailing address

3857 BIRCH ST STE 831
NEWPORT BEACH CA
92660-2616
US

V. Phone/Fax

Practice location:
  • Phone: 714-882-5622
  • Fax: 714-267-2178
Mailing address:
  • Phone: 949-868-9712
  • Fax: 949-850-6996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: JAMES MURRAY
Title or Position: MANAGER
Credential:
Phone: 949-868-9713