Individual provider Active NPI

Quynh-Chau Hoang

  • Physician Assistant
  • Simi Valley, CA
National Provider Identifier
1568930402
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA56249 Issued in CA
Practice address
2525 Erringer Rd
Simi Valley, CA 93065-2352
Phone
(805) 527-1404
Fax
(805) 527-5246
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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 PA56249 CA Primary

Addresses

Primary practice location

2525 Erringer Rd
Simi Valley, CA 93065-2352

Mailing address

5720 Ralston St Ste 200
Ventura, CA 93003-7844
Phone (805) 804-4168

Other identifiers 1

IdentifierTypeStateIssuer
56249OtherCASTATE LICENSE

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
I20190305000548 CA Practitioner - Physician Assistant 3375882681 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56249CAMDDentist
PA56249CAMDPhysician Assistant

Organizations & group practices 5

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": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1568930402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 RALSTON ST STE 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037844",
            "telephone_number": "805-804-4168",
            "fax_number": "805-830-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 ERRINGER RD",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652352",
            "telephone_number": "805-527-1404",
            "fax_number": "805-527-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "QUYNH-CHAU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "56249",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.