Individual provider Active NPI

Ericsson Trieu, PA-C

  • Physician Assistant
  • Whittier, CA
National Provider Identifier
1144685504
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
54702 Issued in CA
Practice address
12456 Washington Blvd
Whittier, CA 90602-1005
Phone
(562) 758-6600
NPI assigned
Dec 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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 54702 CA Primary

Addresses

Primary practice location

12456 Washington Blvd
Whittier, CA 90602-1005

Mailing address

12456 Washington Blvd
Whittier, CA 90602-1005
Phone (562) 758-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160211002438 NV Practitioner - Physician Assistant 2062716061 Reassigns benefits to 1 organization
I20251002000139 CA Practitioner - Physician Assistant 2062716061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12456 Washington Blvd
Whittier, CA 90602-1005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54702CAMDPhysician Assistant

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ericsson.trieu@9998299955204.direct.elationemr.com

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1144685504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12456 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021005",
            "telephone_number": "562-758-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12456 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021005",
            "telephone_number": "562-758-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIEU",
        "first_name": "ERICSSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-29",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.