Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 20A13166 | CA |
NPI | 1003044876 |
---|---|
Provider Name | Geoffrey B Trenkle |
First Address | Los Angeles, CA 90033-2434 |
Second Address | Los Angeles, CA 90033-2434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 18/10/2019 |