Trang D Phan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

34912TLG Issued in CA

Practice address

31573 Rancho Pueblo Rd Ste 101
Temecula, CA 92592-4854

Phone

(951) 302-5580

Fax

(951) 302-5581

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Other names 1

• Dr. Trang D Le Former name

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

First Optometric Care of Northern California PCGroup PAC ID 6002216488, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• First Optometric Care of Northern California PC

  • Optometrist
  • Rancho Cordova, CA
  • NPI 1154972404
  Medicare reassignment Care Compare group NPD
• First Optometric Care of Northern California PC

  • Optometrist
  • San Jose, CA
  • NPI 1487537452
  NPD
• First Optometric Care of Northern California PC

  • Optometrist
  • Temecula, CA
  • NPI 1538754007
  NPD
• First Optometric Care of Northern California PC

  • Optometrist
  • Norwalk, CA
  • NPI 1316532898
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1407817265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 WEST AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782117",
            "telephone_number": "330-630-9699",
            "fax_number": "330-630-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31573 RANCHO PUEBLO RD STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925924854",
            "telephone_number": "951-302-5580",
            "fax_number": "951-302-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TRANG",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5488",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "21354-875",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34912TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "000000376636",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO",
            "identifier": "1407817265",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2604944",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE",
            "identifier": "341572960TL",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00444080",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMERALD HEALTH",
            "identifier": "1407817265",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRANG",
            "last_name": "LE",
            "middle_name": "D",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Phuong Minh Pham, MD
• Tatyana Pham
• Jane N/a Phan, MD
• Jasmine Phan
• Nina Ha Thanh Phan
• Tuyet Mai T Phan, D.D.S
• Van-Quynh Phan
• Pharmasphere Inc
• Allen Martin Phelps, PA-C, MPAS
• Jazmin Phillips

• Optometrist in Temecula, CA
• Providers in Temecula, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.