Provider Demographics
NPI:1114074309
Name:TRINDADE, FILOMENA FATIMA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:FILOMENA
Middle Name:FATIMA
Last Name:TRINDADE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:GUSTINE
Mailing Address - State:CA
Mailing Address - Zip Code:95322-0446
Mailing Address - Country:US
Mailing Address - Phone:831-462-4441
Mailing Address - Fax:831-462-4494
Practice Address - Street 1:720 CAPITOLA AVE STE A
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2784
Practice Address - Country:US
Practice Address - Phone:831-462-4441
Practice Address - Fax:831-426-4494
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG080189207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H30348Medicare UPIN