Trung Truong, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G79604 Issued in CA

Practice address

30492 Gateway PL Ste 110
Rancho Mission Viejo, CA 92694-1899

Phone

(949) 542-7700

Fax

(949) 361-8163

NPI assigned

Nov 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ttruong193597@direct.memorialcare.org

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Pediatrics

  Medicare reassignment NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760

  Pediatrics

  NPD (past)
• Children'S Hospital at Mission

  • Children's Hospital
  • Mission Viejo, CA
  • NPI 1699868398
  NPD (past)
• Children'S Hospital of Orange County

  • Children's Hospital
  • Orange, CA
  • NPI 1811080526
  NPD (past)
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• Long Beach Memorial Medical

  • Children's Hospital
  • Long Beach, CA
  • NPI 1477596583
  NPD (past)
• Mission Hospital Regional Medical Center

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  NPD (past)
• Orange County Global Medical Center, Inc

  • General Acute Care Hospital
  • Santa Ana, CA
  • NPI 1982697678
  NPD (past)
• Saddleback Memorial Medical Center

  • Rehabilitation Hospital Unit
  • Laguna Hills, CA
  • NPI 1114967114
  NPD (past)
• Tien Trong Vu, M.D. Inc.

  • Exclusive Provider Organization
  • Stockton, CA
  • NPI 1588754295
  NPD (past)

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1801877170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30492 GATEWAY PL STE 110",
            "city": "RANCHO MISSION VIEJO",
            "state": "CA",
            "postal_code": "926941899",
            "telephone_number": "949-542-7700",
            "fax_number": "949-361-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30492 GATEWAY PL STE 110",
            "city": "RANCHO MISSION VIEJO",
            "state": "CA",
            "postal_code": "926941899",
            "telephone_number": "949-542-7700",
            "fax_number": "949-361-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "TRUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G79604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G796040",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Kelly Sullivan
• Nanette Tarascio
• Samara Joy Taylor Heller, RD, RDN
• The Orchards HC LLC
• Thrifty Payless Inc
• Vivara Wellness
• Krystal Von Pohle, PT
• Yuqi K Wang, MD
• Lisa Whitley, PT
• Jonathan James Wong, DDS

• Pediatrics Physician in Rancho Mission Viejo, CA
• Providers in Rancho Mission Viejo, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.

Verify at the official NPI Registry.