Individual provider Active NPI

Toan Hung Tran, M.D.

  • General Practice Physician
  • Stockton, CA
National Provider Identifier
1164500773
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A37620 Issued in CA
Practice address
4545 Georgetown PL
C16
Stockton, CA 95207-6215
Phone
(209) 957-0641
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A37620 CA Primary

Addresses

Primary practice location

4545 Georgetown PL
C16
Stockton, CA 95207-6215

Mailing address

4545 Georgetown PL
Ste C16
Stockton, CA 95207-6230
Phone (209) 957-0641

Other identifiers 1

IdentifierTypeStateIssuer
00A376200MedicaidCA

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
I20080424000373 CA Practitioner - General Practice 9436237955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37620CAMDPharmacist
A37620CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Toanhungtran MD Inc General Practice CurrentSince Feb 25, 2008 Accepting new patients

Locations

4545 Georgetown Pl
Ste C16
Stockton, CA 95207
Phone (209) 227-9297

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1164500773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 GEORGETOWN PL",
            "address_2": "STE C16",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076230",
            "telephone_number": "209-957-0641",
            "fax_number": "209-957-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 GEORGETOWN PL",
            "address_2": "C16",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076215",
            "telephone_number": "209-957-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TOAN",
        "middle_name": "HUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A37620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A376200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.