=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922137272
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELLAFLOR V. TROMPETA, M.D., A MEDICAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2007
-----------------------------------------------------
Last Update Date | 04/30/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18433 ROSCOE BLVD STE 104
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-993-9555
-----------------------------------------------------
Fax | 818-993-9558
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18433 ROSCOE BLVD STE 104
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-993-9555
-----------------------------------------------------
Fax | 818-993-9558
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. BELLAFLOR VILLANUEVA TROMPETA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 818-993-9555
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080N0001X
-----------------------------------------------------
Taxonomy Name | Neonatal-Perinatal Medicine Physician
-----------------------------------------------------
License Number | A26147
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | A26147
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------