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General NPI Number Information
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NPI Number | 1629111919
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Entity Type | Organization
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Legal Business Name | INGRID E TRENKLE MD INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 124 E OLIVE AVE
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City | REDLANDS
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State | CA
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Zip | 92373-5250
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Country | US
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Telephone | 909-335-2018
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Fax | 909-335-1641
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Provider Business Mailing Address
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Address Line | 124 E OLIVE AVE
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City | REDLANDS
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State | CA
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Zip | 92373-5250
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Country | US
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Telephone | 909-335-2018
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Fax | 909-335-1641
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | INGRID E TRENKLE
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Credential | MD
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Telephone | 909-335-2018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | G27162
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License Number State | CA
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