Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | A37268 | CA |
NPI | 1114937992 |
---|---|
Provider Name | Rohit R Trivedi |
First Address | Pomona, CA 91767-2900 |
Second Address | Pomona, CA 91767-2900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 18/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A372680 | (05) | CO |
330001800 | RAILROAD PROVIDER (01) | CA |
B50344 | (02) | CA |