Individual provider Active NPI

Adelaine Devera Trask, MD

  • Pediatrics Physician
  • Camp Pendleton, CA
National Provider Identifier
1154525954
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-14866 Issued in HI
Practice address
200 Mercy Circle
Camp Pendleton, CA 92055
Phone
(626) 731-0382
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-14866 HI Primary

Addresses

Primary practice location

200 Mercy Circle
Camp Pendleton, CA 92055

Mailing address

200 Mercy Circle
Camp Pendleton, CA 92055-5191
Phone (760) 725-9453

Other practice location 1

34800 Bob Wilson Dr
Nmcsd
San Diego, CA 92134-1098
Phone (714) 337-0239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-14866HIMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1154525954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-725-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "626-731-0382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_2": "NMCSD",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "714-337-0239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRASK",
        "first_name": "ADELAINE",
        "middle_name": "DEVERA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-14866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.