Individual provider Active NPI

Tramanh Thi Vu, PA-C

  • Physician Assistant
  • Fountain Valley, CA
National Provider Identifier
1376878579
Registry record updated Oct 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19804 Issued in CA
Practice address
11160 Warner Ave
Suite 421
Fountain Valley, CA 92708-4008
Phone
(714) 966-2009
Fax
(714) 966-2372
NPI assigned
Oct 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2009

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 PA19804 CA Primary

Addresses

Primary practice location

11160 Warner Ave
Suite 421
Fountain Valley, CA 92708-4008

Mailing address

11160 Warner Ave
Suite 421
Fountain Valley, CA 92708-4008
Phone (714) 966-2009

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
I20110728000491 CA Practitioner - Physician Assistant 9436327830 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19804CAMDPhysical Therapist
PA19804CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Apr 18, 2015 Accepting new patients
County of Los Angeles CurrentSince Apr 18, 2015 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

Organizations & group practices 2

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": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1376878579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "SUITE 421",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084008",
            "telephone_number": "714-966-2009",
            "fax_number": "714-966-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "SUITE 421",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084008",
            "telephone_number": "714-966-2009",
            "fax_number": "714-966-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "TRAMANH",
        "middle_name": "THI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.