Provider Demographics
NPI:1629161260
Name:TRENKLE, INGRID E (MD)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:E
Last Name:TRENKLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124E OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5250
Mailing Address - Country:US
Mailing Address - Phone:909-798-9403
Mailing Address - Fax:909-335-1641
Practice Address - Street 1:124 E OLIVE AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5250
Practice Address - Country:US
Practice Address - Phone:909-335-2018
Practice Address - Fax:909-335-1641
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27162174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G271620Medicare PIN
CAA89443Medicare UPIN