Provider Demographics
NPI:1689553968
Name:TRUJILLO, ANTHONY (LPTA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:TRUJILLO
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4776 CALLE ESTRELLA
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-5903
Mailing Address - Country:US
Mailing Address - Phone:760-681-8721
Mailing Address - Fax:
Practice Address - Street 1:3915 MISSION AVE STE 7
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-7801
Practice Address - Country:US
Practice Address - Phone:760-547-2854
Practice Address - Fax:877-298-4204
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA543062081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine