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NPI Code Detail

MEDICARE: HUMBERTO TREVINO JR. MD

MEDICARE: HUMBERTO TREVINO JR. MD
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
1207Q00000XFamily Medicine PhysicianDR.0071463CO
2207Q00000XFamily Medicine PhysicianMD217900OR
3207Q00000XFamily Medicine PhysicianA198049CA

General Provider Information

NPI Number : 1841814209
Entity Type Code : Individual
Provider Name (Legal Business Name) : HUMBERTO TREVINO JR. MD
Provider Business Mailing Address
First Line : 75 ROWLAND WAY STE 200
Second Line :
City : NOVATO
State : CA
Zip : 94945-5054
Country : US
Telephone Number : 415-897-9664
Fax Number : 415-892-9589
Provider Business Practice Location Address
First Line : 75 ROWLAND WAY STE 200
Second Line :
City : NOVATO
State : CA
Zip : 94945-5054
Country : US
Telephone Number : 415-897-9664
Fax Number : 415-892-9589
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2020
Last Update Date : 07/25/2025

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