Provider Demographics
NPI:1609037233
Name:TRINIDAD MEDICAL CORPORATION
Entity Type:Organization
Organization Name:TRINIDAD MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-481-3042
Mailing Address - Street 1:3625 MISSION AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2954
Mailing Address - Country:US
Mailing Address - Phone:916-481-3042
Mailing Address - Fax:916-481-3044
Practice Address - Street 1:3625 MISSION AVE
Practice Address - Street 2:SUITE E
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2954
Practice Address - Country:US
Practice Address - Phone:916-481-3042
Practice Address - Fax:916-481-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty