Provider Demographics
NPI:1952416695
Name:BARBADILLO, TERESITA TRIMOR (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:TRIMOR
Last Name:BARBADILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 EUCLID AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2957
Mailing Address - Country:US
Mailing Address - Phone:619-267-8601
Mailing Address - Fax:619-267-2242
Practice Address - Street 1:655 EUCLID AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2957
Practice Address - Country:US
Practice Address - Phone:619-267-8601
Practice Address - Fax:619-267-2242
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-38742208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB-50390Medicare ID - Type Unspecified