Active NPI
Jacqueline Truong, MD
- Family Medicine Physician
- Los Angeles, CA
National Provider Identifier
1215630355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A2091475
- Practice address
- 200 Medical Plaza
Suite 365a
Los Angeles, CA 90024 - Phone
- (310) 206-8272
- NPI assigned
- Mar 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A2091475 | CA | Primary |
Addresses
Primary practice location
200 Medical Plaza
Suite 365a
Los Angeles, CA 90024
Mailing address
1001 Potrero Ave BLDG 80-83
San Francisco, CA 94110-3518
Phone (628) 206-5252
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240307000312 | CA | Order and Referring Only - Family Practice | 2860838307 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786924800000",
"number": "1215630355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 POTRERO AVE BLDG 80-83",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941103518",
"telephone_number": "628-206-5252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL PLAZA",
"address_2": "SUITE 365A",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90024",
"telephone_number": "310-206-8272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUONG",
"first_name": "JACQUELINE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2026-08-17",
"certification_date": "2026-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A2091475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.