Provider Demographics
NPI:1821025313
Name:TRIMZI, MATEEN H (MD)
Entity type:Individual
Prefix:DR
First Name:MATEEN
Middle Name:H
Last Name:TRIMZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SYED
Other - Middle Name:MATEEN
Other - Last Name:HASAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 WEST ARBOR DRIVE MAIL CODE 8485
Mailing Address - Street 2:UCSD MEDICAL CENTER, HILLCREST
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8485
Mailing Address - Country:US
Mailing Address - Phone:619-543-3000
Mailing Address - Fax:
Practice Address - Street 1:200 WEST ARBOR DRIVE MAIL CODE 8485
Practice Address - Street 2:UCSD MEDICAL CENTER, HILLCREST
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8485
Practice Address - Country:US
Practice Address - Phone:619-543-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22171207R00000X
CAA93138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004704Medicaid
WV7341281Medicare ID - Type Unspecified
WV150169Medicare UPIN