Provider Demographics
NPI:1598399917
Name:TRINITY MEDICAL MULTI-SPECIALTY GROUP INC.
Entity Type:Organization
Organization Name:TRINITY MEDICAL MULTI-SPECIALTY GROUP INC.
Other - Org Name:TRINITY MEDICAL MULTI-SPECIALTY GROUP, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INDRANEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAKRABARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-501-4200
Mailing Address - Street 1:PO BOX 2680
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92593-2680
Mailing Address - Country:US
Mailing Address - Phone:951-501-4200
Mailing Address - Fax:951-501-4239
Practice Address - Street 1:31625 DE PORTOLA RD STE 101
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2770
Practice Address - Country:US
Practice Address - Phone:951-501-4200
Practice Address - Fax:951-501-4239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty