Individual provider Active NPI

Phac Van Vo, MD

  • General Practice Physician
  • Long Beach, CA
National Provider Identifier
1205913654
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A43290 Issued in CA
Practice address
611 East Anaheim Street
Long Beach, CA 90813
Phone
(562) 591-8982
Fax
(562) 591-8180
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A43290 CA Primary

Addresses

Primary practice location

611 East Anaheim Street
Long Beach, CA 90813

Mailing address

611 East Anaheim Street
Long Beach, CA 90813
Phone (562) 591-8982

Other identifiers 1

IdentifierTypeStateIssuer
00A432900MedicaidCA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050517000327 CA Practitioner - General Practice 6901847359 Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43290CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Loan T. Truong, M.D., Inc. PastSince Jun 12, 2019 Accepting new patients

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205913654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 EAST ANAHEIM STREET",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90813",
            "telephone_number": "562-591-8982",
            "fax_number": "562-591-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 EAST ANAHEIM STREET",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90813",
            "telephone_number": "562-591-8982",
            "fax_number": "562-591-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "PHAC",
        "middle_name": "VAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A43290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A432900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.