Individual provider Active NPI

Thao Dinh Tomczyk, PA-C

  • Medical Physician Assistant
  • Corona, CA
National Provider Identifier
1306245519
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
51783 Issued in CA
Practice address
341 Magnolia Ave Ste 201
Corona, CA 92879-3332
Phone
(951) 371-6979
Fax
(951) 371-5830
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 51783 CA Primary

Addresses

Primary practice location

341 Magnolia Ave Ste 201
Corona, CA 92879-3332

Mailing address

16118 Skyridge Dr
Riverside, CA 92503-5578
Phone (714) 624-5753

Other names 1

  • Thao Dinh Truong Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51783CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Medical Group, Inc. Physician Assistant Past Accepting new patients
Gage Pediatric Medical Corporation Past Accepting new patients
Aspen Medical Group, Inc. Physician Assistant Past Accepting new patients
Aspen Medical Group, Inc Physician Assistant Past Accepting new patients
Ahmc Greater El Monte Comm Hosp LLC Past Accepting new patients
Hanford Community Hospital Past Accepting new patients

Organizations & group practices 6

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1306245519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16118 SKYRIDGE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035578",
            "telephone_number": "714-624-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793332",
            "telephone_number": "951-371-6979",
            "fax_number": "951-371-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCZYK",
        "first_name": "THAO",
        "middle_name": "DINH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "51783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THAO",
            "last_name": "TRUONG",
            "middle_name": "DINH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.