Provider Demographics
NPI:1104644012
Name:TRIFECTA MEDICAL INC
Entity type:Organization
Organization Name:TRIFECTA MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CIVELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-206-9553
Mailing Address - Street 1:7702 MEANY AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-5199
Mailing Address - Country:US
Mailing Address - Phone:661-843-7830
Mailing Address - Fax:559-223-9907
Practice Address - Street 1:7702 MEANY AVE STE 101
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-5199
Practice Address - Country:US
Practice Address - Phone:661-843-7830
Practice Address - Fax:559-223-9907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty