Juventas West a Professional Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

193400000X Issued in CA

Legal business name

JUVENTAS WEST A PROFESSIONAL MEDICAL CORPORATION

Practice address

410 N Winchester Blvd
Santa Clara, CA 95050-6325

Phone

(650) 888-5728

NPI assigned

Nov 17, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Tien Trinh, MDNPI 1881791135

Title

Owner

Phone

(408) 646-5390

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tien Trinh, M.D.

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1881791135
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1353110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1356685101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 COLLEEN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951234605",
            "telephone_number": "650-888-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N WINCHESTER BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506325",
            "telephone_number": "650-888-5728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "728 Colleen Dr",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951234605",
            "country_code": "US",
            "telephone_number": "650-888-5728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JUVENTAS WEST A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-17",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A",
        "authorized_official_last_name": "TRINH",
        "authorized_official_first_name": "TIEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-646-5390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "193400000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A891760",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00Q796540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.