MEDICARE: GEOFFREY B TRENKLE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YS0123X	Facial Plastic Surgery Physician	20A13166	CA

General Provider Information

NPI Number	:	1003044876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEOFFREY B TRENKLE D.O.

Provider Business Mailing Address
First Line	:	1700 E CESAR E CHAVEZ AVE STE 2500
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-2434
Country	:	US
Telephone Number	:	323-268-6731
Fax Number	:	866-544-2050

Provider Business Practice Location Address
First Line	:	1700 E CESAR E CHAVEZ AVE STE 2500
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-2434
Country	:	US
Telephone Number	:	323-268-6731
Fax Number	:	323-268-6738

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2009
Last Update Date	:	10/18/2019

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