Individual provider Active NPI

Trevor Daniel Link, DO

  • Student in an Organized Health Care Education/Training Program
  • San Bernardino, CA
National Provider Identifier
1063272748
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone
(909) 883-8711
NPI assigned
Mar 20, 2024
Last updated
Apr 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA Primary

Addresses

Primary practice location

2101 N Waterman Ave
San Bernardino, CA 92404-4836

Mailing address

26412V Thackery LN
Stevenson Ranch, CA 91381-1453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801003805 ID Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9436667367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: trevor.link@hca3.eclinicaldirectplus.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1063272748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26412V THACKERY LN",
            "city": "STEVENSON RANCH",
            "state": "CA",
            "postal_code": "913811453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-883-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINK",
        "first_name": "TREVOR",
        "middle_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.