Provider Demographics
NPI:1679861736
Name:TRINA HEALTH OF NEWPORT BEACH, LLC
Entity Type:Organization
Organization Name:TRINA HEALTH OF NEWPORT BEACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:FORD
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-335-2389
Mailing Address - Street 1:1525 SUPERIOR AVE
Mailing Address - Street 2:STE 214
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3639
Mailing Address - Country:US
Mailing Address - Phone:949-722-7902
Mailing Address - Fax:949-722-7903
Practice Address - Street 1:1525 SUPERIOR AVE
Practice Address - Street 2:STE 214
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3639
Practice Address - Country:US
Practice Address - Phone:949-722-7902
Practice Address - Fax:949-722-7903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy