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General NPI Number Information
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NPI Number | 1063508950
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Entity Type | Individual
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Provider Name | TAI TRINH BA-SOCIOLOGY
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 4000 W METROPOLITAN DR # 120
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City | ORANGE
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State | CA
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Zip | 92868-3504
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Country | US
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Telephone | 714-972-9700
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Fax | 714-972-3744
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Provider Business Mailing Address
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Address Line | 24216 SPARKLING SPRING LN
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City | LAKE FOREST
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State | CA
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Zip | 92630-3686
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Country | US
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Telephone | 310-756-5248
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State | CA
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