Provider Demographics
NPI:1518015833
Name:TRILLANES, CAESAR GIL (MD)
Entity Type:Individual
Prefix:
First Name:CAESAR
Middle Name:GIL
Last Name:TRILLANES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 889
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91365-0889
Mailing Address - Country:US
Mailing Address - Phone:818-597-3800
Mailing Address - Fax:818-879-8272
Practice Address - Street 1:1415 ROSS AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4306
Practice Address - Country:US
Practice Address - Phone:760-339-7241
Practice Address - Fax:760-339-7249
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC383832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C383830Medicaid
CARHL115869OtherDHS RADIOLOGY LICENSE
CARHL115869OtherDHS RADIOLOGY LICENSE
CARHL115869OtherDHS RADIOLOGY LICENSE
AT8738621OtherUS DEPT OF JUSTICE DEA