Individual provider Active NPI

Phuong Quy Tran, MD

  • Family Medicine Physician
  • Tustin, CA
National Provider Identifier
1104240928
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A152612 Issued in CA
Practice address
1 Hope Dr
Tustin, CA 92782-0221
Phone
(714) 247-0300
Fax
(714) 259-1598
NPI assigned
Feb 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A152612 CA Primary

Addresses

Primary practice location

1 Hope Dr
Tustin, CA 92782-0221

Mailing address

14642 Newport Ave Ste 300
Tustin, CA 92780-6059
Phone (714) 247-0300

Other practice location 1

14642 Newport Ave Ste 200
Tustin, CA 92780-6058
Phone (714) 247-0300

Other practice location 2

1100B N Tustin Ave Ste A
Santa Ana, CA 92705-3505
Phone (714) 247-0300

Other practice location 3

947 S Anaheim Blvd Ste 260
Anaheim, CA 92805-5591
Phone (714) 247-0300

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221115003129 CA Practitioner - Family Practice 2466703376 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A152612CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurtt Family Health Clinic Inc. CurrentSince Oct 4, 2024 Accepting new patients
Hurtt Family Health Clinic Inc. Past Accepting new patients
Hurtt Family Health Clinic Inc PastSince Oct 4, 2024 Accepting new patients

Locations

947 S Anaheim Blvd
Ste 260
Anaheim, CA 92805

1100 N Tustin Ave
Ste Adf
Santa Ana, CA 92705

1100 N Tustin Ave
Ste A
Santa Ana, CA 92705
Phone (714) 835-6055

14642 Newport Ave
Ste 300
Tustin, CA 92780
Phone (714) 669-4422

14642 Newport Ave
Ste 200
Tustin, CA 92780
Phone (714) 669-4466

1 Hope Dr
Tustin, CA 92782
Phone (714) 247-4398

1 Hope Dr
Ste B
Tustin, CA 92782

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADEBAA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1104240928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE STE 300",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806059",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14642 Newport Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927806058",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100B N Tustin Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053505",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "947 S Anaheim Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055591",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PHUONG",
        "middle_name": "QUY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A152612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.