Individual provider Active NPI

Dan Truong, PA

  • Physician Assistant
  • Palm Springs, CA
National Provider Identifier
1215639315
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62713 Issued in CA
Practice address
3655 E Ramon Rd
Palm Springs, CA 92264-1150
Phone
(760) 327-9400
Fax
(760) 327-9384
NPI assigned
Mar 21, 2023
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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 PA62713 CA Primary

Addresses

Primary practice location

3655 E Ramon Rd
Palm Springs, CA 92264-1150

Mailing address

24711 Court St
San Bernardino, CA 92410-5018

Other practice location 1

24711 Court St
San Bernardino, CA 92410-5018
Phone (909) 272-2233

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013001848 CA Practitioner - Physician Assistant 3779938535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arrae HealthGroup PAC ID 6103202486, 6 clinicians

Practice addresses (Care Compare)

802 Magnolia Ave
Suite 205
Corona, CA 92879-3144
Phone (951) 281-2730

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62713CAMDGeneral Practice Dentistry
PA62713CAMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1215639315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24711 COURT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924105018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 E RAMON RD",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922641150",
            "telephone_number": "760-327-9400",
            "fax_number": "760-327-9384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24711 Court St",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924105018",
            "country_code": "US",
            "telephone_number": "909-272-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "DAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.