Individual provider Active NPI

Khoa Tran, PA-C

  • Physician Assistant
  • Oxnard, CA
National Provider Identifier
1174033807
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58094 Issued in CA
Practice address
360 W Esplanade Dr
Oxnard, CA 93036-1264
Phone
(805) 919-1030
NPI assigned
Oct 9, 2017
Last updated
May 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6942 AZ
Physician Assistant 363A00000X 58094 CA Primary

Addresses

Primary practice location

360 W Esplanade Dr
Oxnard, CA 93036-1264

Mailing address

620 E Janss Rd
Thousand Oaks, CA 91360-5113
Phone (805) 495-6866

Other practice location 1

620 E Janss Rd
Thousand Oaks, CA 91360-5113
Phone (805) 495-6866 ext. 1

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200519001536 CA Practitioner - Physician Assistant 0749547073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cottage Clinical Network LLCGroup PAC ID 1850712530, 57 clinicians

Practice addresses (Care Compare)

1298 Coast Village Rd
Montecito, CA 93108-2719
Phone (805) 569-7847

1708 S Victoria Ave
Suite D
Ventura, CA 93003-6594
Phone (805) 290-4985

1846 N Broadway
Suite a
Santa Maria, CA 93454-1447
Phone (805) 361-4279

3885 State St
Suite a
Santa Barbara, CA 93105-5645
Phone (805) 569-7351

4360 E Main St
Suite D
Ventura, CA 93003-8279
Phone (805) 682-7111

563 W Channel Islands Blvd
Suite B
Port Hueneme, CA 93041-2179
Phone (805) 322-3190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58094CAMDMarriage & Family Therapist
6942AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Express Care, PLLC CurrentSince Oct 16, 2017 Accepting new patients
Cottage Medical Associates Past Accepting new patients

Locations

495 N Pinal Pkwy
Ste 106
Florence, AZ 85132
Phone (520) 568-0573

890 W Elliot Rd
Ste 103
Gilbert, AZ 85233
Phone (480) 241-7564

920 E Williams Field Rd
Ste 101
Gilbert, AZ 85295
Phone (480) 499-0201

3730 W Happy Valley Rd
Ste 100
Glendale, AZ 85310
Phone (623) 277-4140

415 N Val Vista Dr
Ste 101
Mesa, AZ 85213
Phone (480) 654-5661

2860 W Peoria Ave
Ste B
Phoenix, AZ 85029
Phone (602) 283-0595

7850 N Silverbell Rd
Ste 132
Tucson, AZ 85743
Phone (480) 500-2286

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1174033807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E JANSS RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605113",
            "telephone_number": "805-495-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W ESPLANADE DR",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930361264",
            "telephone_number": "805-919-1030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 E Janss Rd",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913605113",
            "country_code": "US",
            "telephone_number": "805-495-6866 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KHOA",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-09",
        "last_updated": "2024-05-07",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6942",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.