Provider Demographics
NPI:1285613125
Name:TROTTER, ALFRED DONALD JR (MD FACS)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:DONALD
Last Name:TROTTER
Suffix:JR
Gender:M
Credentials:MD FACS
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Mailing Address - Street 1:251 LANDIS AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910
Mailing Address - Country:US
Mailing Address - Phone:619-426-1500
Mailing Address - Fax:619-426-1523
Practice Address - Street 1:251 LANDIS AVE
Practice Address - Street 2:STE 204
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910
Practice Address - Country:US
Practice Address - Phone:619-426-1500
Practice Address - Fax:619-426-1523
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
CAA21112207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A211120Medicaid
CA00A211120Medicaid
A22464Medicare UPIN
CAAT1062075OtherDEA