Provider Demographics
NPI:1427695444
Name:TRINIDAD, ANA PATRICIA (PHARMD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:PATRICIA
Last Name:TRINIDAD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 ARMACOST AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1451
Mailing Address - Country:US
Mailing Address - Phone:949-878-6779
Mailing Address - Fax:
Practice Address - Street 1:500 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1404
Practice Address - Country:US
Practice Address - Phone:213-270-6329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist