Active NPI
Phuong Thi Kim Tran, PA-C
- Medical Physician Assistant
- San Diego, CA
National Provider Identifier
1063532232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 18370
- Practice address
- 6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715 - Phone
- (858) 859-1188
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 18370 | CA | Primary |
Addresses
Primary practice location
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Mailing address
10444 Flanders CV
San Diego, CA 92126-3031
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18370 | CA | MD | Acupuncturist |
| PA 18370 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haramandeep Singh MD Inc | Current | Accepting new patients | |
| Bass Medical Group | Past | Accepting new patients |
Locations
2500 Old Crow Canyon Rd
Ste 505
San Ramon, CA 94583
Phone (925) 415-5353
Interoperability endpoints
- https://api.platform.athenahealth.com/2732/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
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- San Ramon, CA
- NPI 1316105802
-
- Specialist
- Walnut Creek, CA
- NPI 1154401941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666828800000",
"number": "1063532232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10444 FLANDERS CV",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921263031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6195 LUSK BLVD STE 250",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213715",
"telephone_number": "858-859-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "PHUONG",
"middle_name": "THI KIM",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2022-10-27",
"certification_date": "2022-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA 18370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.