Provider Demographics
NPI:1720471816
Name:TRIF, LUCIAN GABRIEL
Entity type:Individual
Prefix:MR
First Name:LUCIAN
Middle Name:GABRIEL
Last Name:TRIF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 ANDREA LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-1830
Mailing Address - Country:US
Mailing Address - Phone:925-788-2530
Mailing Address - Fax:925-226-4976
Practice Address - Street 1:1841 ANDREA LN
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-1830
Practice Address - Country:US
Practice Address - Phone:925-788-2530
Practice Address - Fax:925-226-4976
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6020706740376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator