Individual provider Active NPI

Emilie Dung Truong, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1245258524
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10600T Issued in CA
Practice address
1916 Aborn Rd
San Jose, CA 95121-1581
Phone
(408) 270-3600
Fax
(408) 270-0501
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
Yes

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
Optometrist 152W00000X 10600T CA Primary

Addresses

Primary practice location

1916 Aborn Rd
San Jose, CA 95121-1581

Mailing address

1916 Aborn Rd
San Jose, CA 95121-1581
Phone (408) 270-3600

Other identifiers 1

IdentifierTypeStateIssuer
SD0106000MedicaidCA

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
I20101004000283 CA Practitioner - Optometry 8224127139 Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1916 Aborn Rd
San Jose, CA 95121-1581
Phone (408) 270-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10600TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245258524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 ABORN RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211581",
            "telephone_number": "408-270-3600",
            "fax_number": "408-270-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 ABORN RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211581",
            "telephone_number": "408-270-3600",
            "fax_number": "408-270-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "EMILIE",
        "middle_name": "DUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10600T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.