Provider Demographics
NPI:1255372769
Name:TREHAN, YOGESH KUMAR (MD)
Entity type:Individual
Prefix:
First Name:YOGESH
Middle Name:KUMAR
Last Name:TREHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1627
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-3627
Mailing Address - Country:US
Mailing Address - Phone:925-516-4488
Mailing Address - Fax:925-516-4545
Practice Address - Street 1:100 CORTONA WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2287
Practice Address - Country:US
Practice Address - Phone:925-516-4488
Practice Address - Fax:925-516-4545
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67477207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A67477Medicaid
820543547OtherTAX ID
CA00A67477Medicaid
CAZZZ23276ZMedicare ID - Type UnspecifiedMCR GROUP NUMBER
CA00A67477Medicare ID - Type UnspecifiedINDIVIDUAL MCR NUMBER