Individual provider Active NPI

Trisha Luu, PA

  • Medical Physician Assistant
  • Long Beach, CA
National Provider Identifier
1508261256
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3300 E. South Street, Suite 308
Long Beach, CA 90805
Phone
(562) 630-3111
Fax
(562) 630-3107
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 53653 CA
Medical Physician Assistant 363AM0700X TX Primary

Addresses

Primary practice location

3300 E. South Street, Suite 308
Long Beach, CA 90805

Mailing address

950 W Magnolia Ave
Fort Worth, TX 76104-4501
Phone (817) 336-5060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227000952 PA Practitioner - Physician Assistant 7012235062

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Renal Medical Group, Inc. Past Accepting new patients
Southland Renal Medical Group, Inc. Past Accepting new patients

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1508261256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W MAGNOLIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044501",
            "telephone_number": "817-336-5060",
            "fax_number": "817-336-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E. SOUTH STREET, SUITE 308",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90805",
            "telephone_number": "562-630-3111",
            "fax_number": "562-630-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "TRISHA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53653",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.