Provider Demographics
NPI:1124411301
Name:TRINA HEALTH OF WEST LOS ANGELES, LLC
Entity type:Organization
Organization Name:TRINA HEALTH OF WEST LOS ANGELES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUENTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-328-4600
Mailing Address - Street 1:10700 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4768
Mailing Address - Country:US
Mailing Address - Phone:424-328-4600
Mailing Address - Fax:424-293-2930
Practice Address - Street 1:10700 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4768
Practice Address - Country:US
Practice Address - Phone:424-328-4600
Practice Address - Fax:424-293-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy