Provider Demographics
NPI:1588984751
Name:TROTTA, ADAM LEVI (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:LEVI
Last Name:TROTTA
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 1:3251 PLACE DU JARDIN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3851
Mailing Address - Country:US
Mailing Address - Phone:800-604-2461
Mailing Address - Fax:
Practice Address - Street 1:3251 PLACE DU JARDIN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-3851
Practice Address - Country:US
Practice Address - Phone:800-604-2461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD184793207Q00000X, 207RA0401X
TXP2549207Q00000X, 207RA0401X
CAA132993207RA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine