Provider Demographics
NPI:1104892611
Name:TRABUCCO, ARNALDO FRANCESCO (MD)
Entity type:Individual
Prefix:
First Name:ARNALDO
Middle Name:FRANCESCO
Last Name:TRABUCCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6250
Mailing Address - Country:US
Mailing Address - Phone:209-723-2122
Mailing Address - Fax:209-677-8303
Practice Address - Street 1:220 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6250
Practice Address - Country:US
Practice Address - Phone:209-723-2122
Practice Address - Fax:209-677-8303
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC167841208800000X
AZ42374208800000X
NV12132208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200431960Medicaid
NVB58468Medicare UPIN
B58468Medicare UPIN
NVV104128Medicare PIN