Healthcare Provider Details

I. General information

NPI: 1790056414
Provider Name (Legal Business Name): TRI M TRINH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2012
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23861 MCBEAN PKWY STE E24
VALENCIA CA
91355-4457
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 661-753-5461
  • Fax: 661-753-5465
Mailing address:
  • Phone: 310-301-8771
  • Fax: 310-301-8751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA123238
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA123238
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA123238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: