Individual provider Active NPI

John Long Hoang, PA-C

  • Medical Physician Assistant
  • Pomona, CA
National Provider Identifier
1477924132
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
52922 Issued in CA
Practice address
520 E. Foothill Ste C
Pomona, CA 91767-3031
Phone
(909) 398-4895
Fax
(909) 398-4925
NPI assigned
Oct 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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 52922 CA Primary

Addresses

Primary practice location

520 E. Foothill Ste C
Pomona, CA 91767-3031

Mailing address

840 Towne Center Drive
Pomona, CA 91767-5900
Phone (909) 398-1550

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
I20151112002368 CA Practitioner - Physician Assistant 4183934656 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians of Southern California IncGroup PAC ID 8123435658, 7 clinicians
Renu Dermatology and WellnessGroup PAC ID 5395090336, 2 clinicians

Practice addresses (Care Compare)

1624 S Grand Ave
Glendora, CA 91740-5433
Phone (626) 859-2249

1741 W Romneya Dr
Suite E
Anaheim, CA 92801-1805
Phone (714) 215-4516

3235 E Colorado Blvd
Suite 102
Pasadena, CA 91107-3838
Phone (626) 859-2249

9191 Westminster Ave
Garden Grove, CA 92844-2751
Phone (714) 919-9191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52922CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District CurrentSince Oct 7, 2015 Accepting new patients
Kaweah Delta Health Care District CurrentSince Oct 7, 2015 Accepting new patients
Orange County Urgent Care #3, Inc. CurrentSince Dec 5, 2016 Accepting new patients
Renu Dermatology and Wellness CurrentSince Oct 15, 2025 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
California Kidney Specialists PastSince Jan 3, 2022 Accepting new patients
Li Q. Nguyen, MD Past Accepting new patients

Locations

1741 W Romneya Dr
Ste E
Anaheim, CA 92801
Phone (714) 215-4516

2415 E Imperial Hwy
Brea, CA 92821
Phone (714) 255-1640

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

1633 S Court St
Visalia, CA 93277
Phone (559) 624-6090

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5192cc27-2764-47df-a8de-8ad1cf29ade6/

Organizations & group practices 10

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": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1477924132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DRIVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E. FOOTHILL STE C",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673031",
            "telephone_number": "909-398-4895",
            "fax_number": "909-398-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "JOHN",
        "middle_name": "LONG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-07",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "52922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.