Provider Demographics
NPI:1093894222
Name:TRINKA, TERENCE A I (OD CN)
Entity Type:Individual
Prefix:DR
First Name:TERENCE
Middle Name:A
Last Name:TRINKA
Suffix:I
Gender:M
Credentials:OD CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26689 PLEASANT PARK RD
Mailing Address - Street 2:#150
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-7703
Mailing Address - Country:US
Mailing Address - Phone:303-838-9355
Mailing Address - Fax:303-838-9526
Practice Address - Street 1:26689 PLEASANT PARK RD
Practice Address - Street 2:#150
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-7703
Practice Address - Country:US
Practice Address - Phone:303-838-9355
Practice Address - Fax:303-838-9526
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO000895133N00000X
COCO1157152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT8836Medicare PIN
CO42003Medicare UPIN