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General NPI Number Information
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NPI Number | 1548231244
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Entity Type | Individual
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Provider Name | WILLIAM VERNON TRABOLD D.C
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 8725 LA TIJERA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90045-3906
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Country | US
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Telephone | 424-331-5661
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Fax | 310-760-2033
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Provider Business Mailing Address
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Address Line | 8725 LA TIJERA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90045-3906
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Country | US
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Telephone | 424-331-5661
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Fax | 310-760-2033
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1266
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC22873
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License Number State | CA
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