Provider Demographics
NPI:1316981699
Name:TRAYNOR, JEFFREY D (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:TRAYNOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 TAMPICO STE 100
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2961
Mailing Address - Country:US
Mailing Address - Phone:925-891-9033
Mailing Address - Fax:925-891-9066
Practice Address - Street 1:110 TAMPICO STE 100
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2961
Practice Address - Country:US
Practice Address - Phone:925-891-9033
Practice Address - Fax:925-891-9066
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68616207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A686160Medicaid
CA00A686160Medicaid
CAG98019Medicare PIN