Provider Demographics
NPI:1306621461
Name:OROT, TREVOR JOSEPH LEAL
Entity type:Individual
Prefix:
First Name:TREVOR JOSEPH
Middle Name:LEAL
Last Name:OROT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 3RD AVE APT RMB
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2719
Mailing Address - Country:US
Mailing Address - Phone:510-825-9748
Mailing Address - Fax:
Practice Address - Street 1:1322 3RD AVE APT RMB
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2719
Practice Address - Country:US
Practice Address - Phone:510-825-9748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program