Individual provider Active NPI

Laurie M. Trombla, PA-C

  • Physician Assistant
  • San Pablo, CA
National Provider Identifier
1245253871
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13720 Issued in CA
Practice address
2000 Vale Rd
San Pablo, CA 94806-3808
Phone
(510) 970-5140
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13720 CA Primary

Addresses

Primary practice location

2000 Vale Rd
San Pablo, CA 94806-3808

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081215000782 CA Practitioner - Physician Assistant 9739241415 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13720CAMDOptometrist
PA13720CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince May 17, 2000 Accepting new patients
Lifelong Medical Care CurrentSince May 17, 2000 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

Interoperability endpoints

  • Direct secure messaging: ltrombla281179@direct.ochin.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245253871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 VALE RD",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063808",
            "telephone_number": "510-970-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBLA",
        "first_name": "LAURIE",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.