Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | C43279 | CA |
NPI | 1447321427 |
---|---|
Provider Name | Blanca Esthela Trevino-Scatterday |
First Address | Orange, CA 92868 |
Second Address | Orange, CA 92868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 10/12/2015 |