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General NPI Number Information
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NPI Number | 1790170769
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Entity Type | Individual
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Provider Name | TREVOR CREAN D.O
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Gender | Male
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 3200 BROADMOOR BLVD NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-2105
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Country | US
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Telephone | 505-994-7397
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone | 505-272-1476
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 5101021715
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A-2469-21
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License Number State | NM
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