Provider Demographics
NPI:1730886235
Name:TWG MEDICAL CAN
Entity type:Organization
Organization Name:TWG MEDICAL CAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-888-5728
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:408-809-7525
Mailing Address - Fax:
Practice Address - Street 1:340 DARDANELLI LN STE 24
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1418
Practice Address - Country:US
Practice Address - Phone:408-378-8648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care