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1821801606 NPI number — TRINITY MED PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION

NPI Number: 1821801606
Health Care Provider/Practitioner: TRINITY MED PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION

Information about “1821801606” NPI (TRINITY MED PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION) exists in 1821801606 in HTML format HTML  |  1821801606 in plain Text format TXT  |  1821801606 in PDF (Portable Document Format) PDF  |  1821801606 in an XML format XML  formats.

NPI Number : 1821801606 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821801606",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "TRINITY MED PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "15421 E GALE AVE UNIT 92125",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CITY OF INDUSTRY",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91715-3896",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "626-290-7055",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "15421 E GALE AVE UNIT 92125",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CITY OF INDUSTRY",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91715-3896",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "626-290-7055",
    "PracticeLocationAddressFaxNumber": "800-448-1194",
    "EnumerationDate": "01/28/2025",
    "LastUpdateDate": "01/30/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BARRERA",
    "AuthorizedOfficialFirstName": "GABRIEL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PA",
    "AuthorizedOfficialTelephoneNumber": "626-290-7055",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QP2300X",
        "TaxonomyName": "Primary Care Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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