Provider Demographics
NPI:1407888191
Name:BOGART, TRINA L
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:L
Last Name:BOGART
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:TRINA
Other - Middle Name:
Other - Last Name:BOGART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 173817
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-8643
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:2000 N. BOISE AVE.
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-7282
Practice Address - Country:US
Practice Address - Phone:970-635-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23629207P00000X
COCDRH.0047176207RA0401X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99723875Medicaid
AZZ71589Medicare PIN
CO99723875Medicaid
COCO303171Medicare PIN