Individual provider Active NPI

Tien Thuy Phan Truong, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Anaheim, CA
National Provider Identifier
1831941277
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64304 Issued in CA
Practice address
100 S Anaheim Blvd Ste 250
Anaheim, CA 92805-3872
Phone
(714) 527-6000
Fax
(714) 527-2371
NPI assigned
Apr 1, 2024
Last updated
Jul 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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 64304 CA Primary

Addresses

Primary practice location

100 S Anaheim Blvd Ste 250
Anaheim, CA 92805-3872

Mailing address

100 S Anaheim Blvd Ste 250
Anaheim, CA 92805-3872
Phone (714) 527-6000

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
I20250905003736 CA Practitioner - Physician Assistant 0941702278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oc GastrocareGroup PAC ID 3779716501, 10 clinicians

Practice addresses (Care Compare)

100 S Anaheim Blvd
Suite 250
Anaheim, CA 92805-3872
Phone (714) 527-6000

408 S Beach Blvd
Suite 211
Anaheim, CA 92804-1869

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64304CAMDDental Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1831941277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S ANAHEIM BLVD STE 250",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053872",
            "telephone_number": "714-527-6000",
            "fax_number": "714-527-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ANAHEIM BLVD STE 250",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053872",
            "telephone_number": "714-527-6000",
            "fax_number": "714-527-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "TIEN",
        "middle_name": "THUY PHAN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.