Provider Demographics
NPI:1922137272
Name:BELLAFLOR V. TROMPETA, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BELLAFLOR V. TROMPETA, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BELLAFLOR
Authorized Official - Middle Name:VILLANUEVA
Authorized Official - Last Name:TROMPETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-993-9555
Mailing Address - Street 1:18433 ROSCOE BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325
Mailing Address - Country:US
Mailing Address - Phone:818-993-9555
Mailing Address - Fax:818-993-9558
Practice Address - Street 1:18433 ROSCOE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325
Practice Address - Country:US
Practice Address - Phone:818-993-9555
Practice Address - Fax:818-993-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26147208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A261470Medicaid