Active NPI
Hong Matta Thi Truong, OD
- Optometrist
- Stockton, CA
National Provider Identifier
1730619867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 33696TLG
- Practice address
- 10734 Trinity Pkwy Ste C
Stockton, CA 95219-7232 - Phone
- (209) 715-6864
- NPI assigned
- Jun 12, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 33696TLG | CA | Primary |
Addresses
Primary practice location
10734 Trinity Pkwy Ste C
Stockton, CA 95219-7232
Mailing address
10734 Trinity Pkwy Ste C
Stockton, CA 95219-7232
Phone (209) 423-4115
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200608000679 | CA | Practitioner - Optometry | 6709207376 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33696TLG | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641081600000",
"number": "1730619867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10734 TRINITY PKWY STE C",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952197232",
"telephone_number": "209-423-4115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10734 TRINITY PKWY STE C",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952197232",
"telephone_number": "209-715-6864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUONG",
"first_name": "HONG MATTA",
"middle_name": "THI",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-12",
"last_updated": "2022-01-02",
"certification_date": "2022-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "33696TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.