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NPI Code Detail

MEDICARE: JORGE LUIS TRUJILLO

MEDICARE: JORGE LUIS TRUJILLO
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner18983CA
2163WP0808XPsychiatric/Mental Health Registered Nurse597263CA

General Provider Information

NPI Number : 1801978374
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE LUIS TRUJILLO
Provider Business Mailing Address
First Line : 1920 MARENGO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1317
Country : US
Telephone Number : 323-276-6400
Fax Number :
Provider Business Practice Location Address
First Line : 2640 INDUSTRY WAY
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-4284
Country : US
Telephone Number : 310-631-8004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 08/27/2025

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Directions to “ JORGE LUIS TRUJILLO ” Practice Location

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