Provider Demographics
NPI:1760511018
Name:TRASK MEDICAL CENTER
Entity Type:Organization
Organization Name:TRASK MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FIROOZ
Authorized Official - Suffix:
Authorized Official - Credentials:OMD, PT
Authorized Official - Phone:714-890-3638
Mailing Address - Street 1:7040 TRASK AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-2622
Mailing Address - Country:US
Mailing Address - Phone:714-890-3638
Mailing Address - Fax:714-890-6012
Practice Address - Street 1:7040 TRASK AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-2622
Practice Address - Country:US
Practice Address - Phone:714-890-3638
Practice Address - Fax:714-890-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT5610111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty