Provider Demographics
NPI:1164624813
Name:KEVIN D. TRINH, MD AND JOHN L. BRAZILL, MD, A MEDICAL CORP.
Entity type:Organization
Organization Name:KEVIN D. TRINH, MD AND JOHN L. BRAZILL, MD, A MEDICAL CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRAZILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-395-1335
Mailing Address - Street 1:2323 16TH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3420
Mailing Address - Country:US
Mailing Address - Phone:661-395-1335
Mailing Address - Fax:
Practice Address - Street 1:2323 16TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3420
Practice Address - Country:US
Practice Address - Phone:661-395-1335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty