Individual provider Active NPI

Edward Tran, OD

  • Optometrist
  • Orange, CA
National Provider Identifier
1124558069
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33690-TLG Issued in CA
Practice address
141 N Glassell St
Orange, CA 92866-1406
Phone
(657) 650-2020
Fax
(657) 650-2021
NPI assigned
Jun 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT33690-TLG CA Primary

Addresses

Primary practice location

141 N Glassell St
Orange, CA 92866-1406

Mailing address

141 N Glassell St
Orange, CA 92866-1406
Phone (657) 650-2020

Other practice location 1

9636 Garden Grove Blvd Ste 5
Garden Grove, CA 92844-1590
Phone (714) 537-1313

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170725002344 CA Practitioner - Optometry 7315217239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Wellness Centers USAGroup PAC ID 1759665367, 30 clinicians
Hello Optometry IncGroup PAC ID 4789080839, 2 clinicians

Practice addresses (Care Compare)

1360 E Anaheim St
Suite 101
Long Beach, CA 90813-5514

141 N Glassell St
Orange, CA 92866-1406
Phone (657) 650-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT33690-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Wellness Centers USA CurrentSince Feb 10, 2025 Accepting new patients
Hello Optometry, Inc. Optometrist CurrentSince May 8, 2021 Accepting new patients
Community Medical Wellness Centers USA CurrentSince Feb 10, 2025 Accepting new patients
Mi Mi Optometric Center Inc Optometrist PastSince May 3, 2010 Accepting new patients
Pacific Optometric Group Optometrist PastSince Feb 9, 2025 Accepting new patients
Mi Mi Optometric Center,Inc Optometrist Past Accepting new patients

Locations

1360 E Anaheim St
Ste 101
Long Beach, CA 90813
Phone (562) 270-0324

141 N Glassell St
Orange, CA 92866
Phone (657) 223-3140

Organizations & group practices 6

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1124558069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N GLASSELL ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661406",
            "telephone_number": "657-650-2020",
            "fax_number": "657-650-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N GLASSELL ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661406",
            "telephone_number": "657-650-2020",
            "fax_number": "657-650-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9636 Garden Grove Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928441590",
            "country_code": "US",
            "telephone_number": "714-537-1313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "EDWARD",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33690-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.