MEDICARE: DR. GABRIEL DAVID TRINCADO DPT

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	2251X0800X	Orthopedic Physical Therapist	P21450	NC
2	225100000X	Physical Therapist	2305214699	VA
3	225100000X	Physical Therapist	P21450	NC

General Provider Information

NPI Number	:	1356012868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIEL DAVID TRINCADO DPT

Provider Business Mailing Address
First Line	:	8505 COOL VISTA LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-6899
Country	:	US
Telephone Number	:	919-808-4592
Fax Number	:	984-202-2919

Provider Business Practice Location Address
First Line	:	8505 COOL VISTA LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-6899
Country	:	US
Telephone Number	:	919-808-4592
Fax Number	:	984-202-2919

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

Provider Enumeration Date	:	09/23/2021
Last Update Date	:	12/10/2025

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