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General NPI Number Information
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NPI Number | 1073400651
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Entity Type | Organization
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Legal Business Name | TRIDENT MEDICAL EVALUATORS, LLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1198 PACIFIC COAST HWY STE D #519
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City | SEAL BEACH
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State | CA
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Zip | 90740-6200
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Country | US
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Telephone | 714-882-5622
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Fax | 714-267-2178
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Provider Business Mailing Address
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Address Line | 3857 BIRCH ST STE 831
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2616
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Country | US
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Telephone | 949-868-9712
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Fax | 949-850-6996
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Authorized Official
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Title or Position | MANAGER
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Name | JAMES MURRAY
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Credential |
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Telephone | 949-868-9713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number |
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License Number State |
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