Healthcare Provider Details

I. General information

NPI: 1104273184
Provider Name (Legal Business Name): TREVOR EDWARD CLINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1463 FINNEGAN LN UNIT E
NORTH BRUNSWICK NJ
08902-5025
US

IV. Provider business mailing address

916 CAYLEY AVE
SAN MARCOS CA
92069-7360
US

V. Phone/Fax

Practice location:
  • Phone: 866-239-1650
  • Fax:
Mailing address:
  • Phone: 512-565-9211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101289250
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number352403
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number247137
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME181949
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01100260A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number0101289250
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2026-03106
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD.70139263
License Number StateWA
# 9
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number29604
License Number StateNV
# 10
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number111524
License Number StateGA
# 11
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD230957
License Number StateOR
# 12
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number247137
License Number StateTN
# 13
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA163944
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: