Organization Active NPI

Nicholas Thanh Quang Tran MD a

  • Medical Specialty Clinic/Center
  • Westminster, CA
National Provider Identifier
1013277763
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
A67914 Issued in CA
Legal business name
NICHOLAS THANH QUANG TRAN MD A
Practice address
15651 Brookhurst St
Westminster, CA 92683-7556
Phone
(714) 531-6969
NPI assigned
May 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Authorized official

Name
Nicholas TranNPI 1265498349
Title
President
Phone
(714) 531-6969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X A67914 CA Primary

Addresses

Primary practice location

15651 Brookhurst St
Westminster, CA 92683-7556

Mailing address

15651 Brookhurst St
Westminster, CA 92683-7556
Phone (714) 531-6969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120716000117 CA Part B Supplier - Clinic/Group Practice 9739345927 Receives reassigned benefits from 1 practitioner
Practice locations: Westminster, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1012350Nicholas Thanh Tran, MD15651 Brookhurst St, Westminster, CA 92683Certificate of waiverMay 7, 2027

National Provider Directory

National Provider Directory

Locations

15651 Brookhurst St
Westminster, CA 92683
Phone (626) 475-7663

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1013277763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15651 BROOKHURST ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926837556",
            "telephone_number": "714-531-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15651 BROOKHURST ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926837556",
            "telephone_number": "714-531-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS THANH QUANG TRAN MD A",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-531-6969"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A67914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.