Provider Demographics
NPI:1831668508
Name:TRINH, PETER T (PA-C)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:T
Last Name:TRINH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 WORSHAM AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1766
Mailing Address - Country:US
Mailing Address - Phone:562-595-5421
Mailing Address - Fax:562-426-2862
Practice Address - Street 1:3833 WORSHAM AVE STE 300
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1766
Practice Address - Country:US
Practice Address - Phone:562-595-5421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-24
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
CA59749207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology