=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043585557
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | QUOC-DIEN TRINH M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2012
-----------------------------------------------------
Last Update Date | 12/23/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5200 CENTRE AVENUE UPMC SHADYSIDE MEDICAL BUILDING SUITE 209
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15232-1312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-605-3065
-----------------------------------------------------
Fax | 412-605-3030
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5200 CENTRE AVENUE UPMC SHADYSIDE MEDICAL BUILDING SUITE 209
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15232-1312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-605-3065
-----------------------------------------------------
Fax | 412-605-3030
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | 4301097311
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | 252332
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | MD486895
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------