Tim Van Luong, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16671 Issued in CA

Practice address

7761 Garden Grove Blvd
Garden Grove, CA 92841-4200

Phone

(714) 898-8888

Fax

(714) 901-7580

NPI assigned

Jun 29, 2009

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tim.luong@nhanhoa.directbygreenway.com

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.

• Pacifica Health & Wellness Clinic, Inc.

  • General Practice Physician
  • Riverside, CA
  • NPI 1538497813

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1992933055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6958 NEW RIDGE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064912",
            "telephone_number": "951-780-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7761 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928414200",
            "telephone_number": "714-898-8888",
            "fax_number": "714-901-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "TIM",
        "middle_name": "VAN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Honghoa Thi Luong, DDS
• Jamie Luong, OTD, OTR/L
• Kimberly Luong
• Sandra Luong, RN
• Tien V Luong, D.D.S.
• Arleena Lupercio, COTA
• Priscilla Lupercio
• Yvette Beaven Lupercio
• Caitlin Quynh-Nhu Luu
• Jasmine Luu

• Physician Assistant in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.

Verify at the official NPI Registry.