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General NPI Number Information
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NPI Number | 1841814209
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Entity Type | Individual
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Provider Name | HUMBERTO TREVINO JR. MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 75 ROWLAND WAY STE 200
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City | NOVATO
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State | CA
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Zip | 94945-5054
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Country | US
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Telephone | 415-897-9664
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Fax | 415-892-9589
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Provider Business Mailing Address
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Address Line | 75 ROWLAND WAY STE 200
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City | NOVATO
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State | CA
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Zip | 94945-5054
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Country | US
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Telephone | 415-897-9664
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Fax | 415-892-9589
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0071463
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD217900
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A198049
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License Number State | CA
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