Organization
TRINITY UROLOGICAL AND SURGICAL, INC.
Active
Other names
Montebello Urological Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER YACOUB (OFFICE MANAGER)
(323) 720-9204
Entity
Organization
Contact information
Practice address
101 E BEVERLY BLVD STE 300, MONTEBELLO, CA 90640-4316
(323) 728-9300
(323) 728-0184
Mailing address
126 S MONTEBELLO BLVD, MONTEBELLO, CA 90640-4730
(323) 720-9204
(323) 720-9208
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A40189
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0070630
—
CA
01
—
W13112
MEDICARE
CA
Enumeration date
09/09/2008
Last updated
09/09/2008
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