Individual provider Active NPI

Loan Thanh Truong, M.D.

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1619317450
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A139072 Issued in CA
Practice address
855 E Anaheim St
Long Beach, CA 90813-3550
Phone
(562) 591-0840
Fax
(562) 591-4191
NPI assigned
Jun 25, 2013
Last updated
Sep 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125063300 IL
Family Medicine Physician 207Q00000X A139072 CA Primary

Addresses

Primary practice location

855 E Anaheim St
Long Beach, CA 90813-3550

Mailing address

855 E Anaheim St
Long Beach, CA 90813-3550
Phone (562) 591-0840

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170111001114 CA Practitioner - Family Practice 9133400195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Loan T Truong MD IncGroup PAC ID 8224319280, 3 clinicians

Practice addresses (Care Compare)

709 E Anaheim St
Long Beach, CA 90813-3507
Phone (562) 591-0840

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A139072CAMDFamily Medicine Physician
125063300ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loan T. Truong, M.D., Inc. Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
Dignity Health Past Accepting new patients

Locations

709 E Anaheim St
Long Beach, CA 90813
Phone (562) 591-0840

855 E Anaheim St
Long Beach, CA 90813
Phone (562) 591-0840

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1619317450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133550",
            "telephone_number": "562-591-0840",
            "fax_number": "562-591-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133550",
            "telephone_number": "562-591-0840",
            "fax_number": "562-591-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "LOAN",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125063300",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A139072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.