Provider Demographics
NPI:1386941912
Name:TROVATO MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:TROVATO MEDICAL GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PARMJIT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-656-5700
Mailing Address - Street 1:5763 STEVENSON BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-5301
Mailing Address - Country:US
Mailing Address - Phone:510-656-5700
Mailing Address - Fax:510-656-5704
Practice Address - Street 1:5763 STEVENSON BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-5301
Practice Address - Country:US
Practice Address - Phone:510-656-5700
Practice Address - Fax:510-656-5704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QU0200X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty