Dr. Trevor John Derderian
Vascular Surgeon
71780 San Jacinto Dr Bldg I
Rancho Mirage
, California 92270-5516
Dr. Trevor John Derderian
Vascular Surgeon
71780 San Jacinto Dr Bldg I
Rancho Mirage
, California 92270-5516
(760) 568-3461
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Trevor John Derderian
- 71780 San Jacinto Dr Bldg. I
- Rancho Mirage, CA
- Zip : 92270-5516
- Phone : (760) 568-3461
Second Address
- Dr. Trevor John Derderian
- 71780 San Jacinto Dr Bldg I
- Rancho Mirage, CA
- Zip : 92270-5516
- Phone : (760) 568-3461
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | 148584 | CA |
National Provider Identifier
| NPI | 1124346697 |
|---|---|
| Provider Name | Dr. Trevor John Derderian |
| First Address | Rancho Mirage, CA 92270-5516 |
| Second Address | Rancho Mirage, CA 92270-5516 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/05/2010 |
| Last Update Date | 03/03/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.