Provider Demographics
NPI:1881092831
Name:DAVID J TRUMBO PC
Entity type:Organization
Organization Name:DAVID J TRUMBO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-429-4052
Mailing Address - Street 1:9017 HARLAN ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2901
Mailing Address - Country:US
Mailing Address - Phone:303-429-4052
Mailing Address - Fax:303-427-4061
Practice Address - Street 1:9017 HARLAN ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-2901
Practice Address - Country:US
Practice Address - Phone:303-429-4052
Practice Address - Fax:303-427-4061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO885152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty