Healthcare Provider Details

I. General information

NPI: 1093894222
Provider Name (Legal Business Name): TERENCE A TRINKA I O.D. CN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26689 PLEASANT PARK RD #150
CONIFER CO
80433-7703
US

IV. Provider business mailing address

26689 PLEASANT PARK RD #150
CONIFER CO
80433-7703
US

V. Phone/Fax

Practice location:
  • Phone: 303-838-9355
  • Fax: 303-838-9526
Mailing address:
  • Phone: 303-838-9355
  • Fax: 303-838-9526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number000895
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberCO1157
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: