Individual provider Active NPI

Quyen The Truong, OD

  • Optometrist
  • Elk Grove, CA
National Provider Identifier
1205305547
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT34146-TLG Issued in CA
Practice address
8511 Tambor Way
Elk Grove, CA 95758-7217
Phone
(916) 430-8424
NPI assigned
Nov 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT34146-TLG CA Primary

Addresses

Primary practice location

8511 Tambor Way
Elk Grove, CA 95758-7217

Mailing address

8511 Tambor Way
Elk Grove, CA 95758-7217
Phone (916) 430-8424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190918001919 CA Practitioner - Optometry 0244560209 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT34146-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Q Truong Optometry Corp Optometrist CurrentSince Jul 25, 2022 Accepting new patients
Fred WM Stellhorn Optometric Corporation Optometrist CurrentSince Aug 1, 2019 Accepting new patients
Q Truong Optometry Corp CurrentSince Jan 26, 2022 Accepting new patients

Locations

140 N Fremont St
Manteca, CA 95336

140 N Fremont St
Ste A
Manteca, CA 95336
Phone (209) 823-3151

8240 Calvine Rd
Ste F
Sacramento, CA 95828
Phone (916) 430-8424

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1205305547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 TAMBOR WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587217",
            "telephone_number": "916-430-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8511 TAMBOR WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587217",
            "telephone_number": "916-430-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "QUYEN",
        "middle_name": "THE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT34146-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.