Individual
ARIEL TRONCOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1080 EMELINE AVE, SANTA CRUZ, CA 95060-1966
(831) 454-4971
(831) 454-4663
Mailing address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4170
(831) 454-4663
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
G30831
CA
2084P0800X
Psychiatry Physician
G30831
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G308312
—
CA
01
—
G30831
PROFESSIONAL LICENSE
CA
01
—
ZZZ91891Z
MEDICARE GROUP ID#
CA
01
—
ZZZ91892Z
MEDICARE GROUP ID#
CA
01
—
ZZZ92069Z
MEDICARE GROUP ID#
CA
01
—
ZZZ92073Z
MEDICARE GROUP ID#
CA
Enumeration date
10/19/2007
Last updated
03/07/2023
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