MEDICARE: DR. VERA TROFIMENKO M.D., M.A.S.

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	208800000X	Urology Physician	150027	CA

General Provider Information

NPI Number	:	1518224112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERA TROFIMENKO M.D., M.A.S.

Provider Business Mailing Address
First Line	:	1801 N BROADWAY
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-2626
Country	:	US
Telephone Number	:	714-984-6640
Fax Number	:	714-984-6604

Provider Business Practice Location Address
First Line	:	1801 N BROADWAY
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-2626
Country	:	US
Telephone Number	:	714-984-6640
Fax Number	:	714-984-6604

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

Provider Enumeration Date	:	04/19/2012
Last Update Date	:	03/18/2025

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