Basic Information
Provider Information
NPI: 1518350594
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRENBEATH
FirstName: ZACHARY
MiddleName: TY
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12631 E 17TH AVE
Address2: ROOM 2414
City: AURORA
State: CO
PostalCode: 800452527
CountryCode: US
TelephoneNumber: 7208480000
FaxNumber:  
Practice Location
Address1: 12605 E 16TH AVE
Address2:  
City: AURORA
State: CO
PostalCode: 800452545
CountryCode: US
TelephoneNumber: 7208480000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/14/2015
LastUpdateDate: 07/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X61915COY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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