Black, Trevor Elan

Black, Trevor Elan is an individual health care provider with primary practice located at 20 Glenlake Pkwy Kaiser Permanente Glenlake Medical Center, Atlanta GA 30328-3473. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Black, Trevor Elan can be contacted via phone (818) 326-1058.

Contact Information

Primary practice address
20 Glenlake Pkwy Kaiser Permanente Glenlake Medical Center Atlanta GA 30328-3473
Phone: (818) 326-1058
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X POD001289 Georgia

Profile Details

NPI number 1861835308
LBN Legal business name Black, Trevor Elan
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2013
Last updated Jan 10th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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