Provider Demographics
NPI:1528265717
Name:TRIMBLE, ROBERT ROSS (RPT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ROSS
Last Name:TRIMBLE
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3669 CITRUS ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-1982
Mailing Address - Country:US
Mailing Address - Phone:909-425-2603
Mailing Address - Fax:
Practice Address - Street 1:3669 CITRUS ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-1982
Practice Address - Country:US
Practice Address - Phone:909-425-2603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist