Provider Demographics
NPI:1720774466
Name:TWG MEDICAL CAC
Entity type:Organization
Organization Name:TWG MEDICAL CAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-440-0750
Mailing Address - Street 1:1627 HILL TOP VIEW TER
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-2710
Mailing Address - Country:US
Mailing Address - Phone:408-440-0750
Mailing Address - Fax:
Practice Address - Street 1:347 E BARSTOW AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6039
Practice Address - Country:US
Practice Address - Phone:408-440-0750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care