Individual provider Active NPI

Anhdao Dinh Uong

  • Physician Assistant
  • Loma Linda, CA
National Provider Identifier
1619703311
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65515 Issued in CA
Practice address
24785 Stewart St RM 201
Loma Linda, CA 92350-1721
Phone
(909) 558-7295
NPI assigned
Sep 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA
Physician Assistant 363A00000X PA65515 CA Primary

Addresses

Primary practice location

24785 Stewart St RM 201
Loma Linda, CA 92350-1721

Mailing address

12241 Loya River Ave
Fountain Valley, CA 92708-1330
Phone (714) 366-9053

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
I20241230003150 CA Practitioner - Physician Assistant 0840727046 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65515CAMDPharmacist
PA65515CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: telemed2u.anhdaouong@160918.advancedmd-direct.com

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": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1619703311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12241 LOYA RIVER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081330",
            "telephone_number": "714-366-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24785 STEWART ST RM 201",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501721",
            "telephone_number": "909-558-7295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UONG",
        "first_name": "ANHDAO",
        "middle_name": "DINH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.