Trung Phan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

15031 Issued in CA

Practice address

1150 Harter Pkwy
Yuba City, CA 95993-2642

Phone

(530) 751-0158

Fax

(530) 751-0123

NPI assigned

Jul 7, 2014

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

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyec Vision Professional Optometry CorpGroup PAC ID 8426489766, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eyec Vision Professional Optometry Corp.

  • Optometrist
  • Yuba City, CA
  • NPI 1881159531
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1881000164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3766 LAKE KATIE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958347697",
            "telephone_number": "408-505-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 HARTER PKWY",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959932642",
            "telephone_number": "530-751-0158",
            "fax_number": "530-751-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TRUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Peters, PPS
• Veronique Peterson, PH.D.
• Atenea Petrucci, PA-C
• Kiranjit Kaur Phagura
• Binh T Pham, RPH
• Dewayne Anthony Phelan
• Philip Cummings DDS
• Jeffrey L Phillips, MD
• Physical Therapy Esssentials
• Rebecca Pierce

• Optometrist in Yuba City, CA
• Providers in Yuba City, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.