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Organization
TRIDENT MEDICAL GROUP INC.
Active
Organization
TRIDENT MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NYRA KHETARPAL MD (PRESIDENT)
(484) 557-9511
Entity
Organization
Contact information
Practice address
18564 US HIGHWAY 18 STE 103&104, APPLE VALLEY, CA 92307-2312
(760) 242-9262
Mailing address
14050 RIVERSIDE DR, APPLE VALLEY, CA 92307-5335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/14/2023
Last updated
03/05/2024
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