Provider Demographics
NPI:1821801606
Name:TRINITY MED PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:TRINITY MED PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:626-290-7055
Mailing Address - Street 1:15421 E GALE AVE UNIT 92125
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91715-3896
Mailing Address - Country:US
Mailing Address - Phone:626-290-7055
Mailing Address - Fax:
Practice Address - Street 1:15421 E GALE AVE UNIT 92125
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91715-3896
Practice Address - Country:US
Practice Address - Phone:626-290-7055
Practice Address - Fax:800-448-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care