Individual provider Active NPI

Dan Tran, PA-C

  • Physician Assistant
  • Whittier, CA
National Provider Identifier
1174991954
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52886 Issued in CA
Practice address
12401 Washington Blvd
Whittier, CA 90602-1006
Phone
(562) 698-0811
NPI assigned
Sep 10, 2015
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52886 CA Primary

Addresses

Primary practice location

12401 Washington Blvd
Whittier, CA 90602-1006

Mailing address

12401 Washington Blvd
Whittier, CA 90602-1006
Phone (562) 698-0811

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
I20160502000811 CA Practitioner - Physician Assistant 1557660230 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 E 4TH St
Suite 104
Santa Ana, CA 92705-3916
Phone (657) 230-7800

610 E Katella Ave
Orange, CA 92867-4954
Phone (714) 694-2001

631 S Brookhurst St
Suite 101
Anaheim, CA 92804-3563
Phone (714) 991-5700

6502 Bolsa Ave
Suite 105
Huntington Beach, CA 92647-2662
Phone (714) 373-2400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52886CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Oc Urgentcare Medical Group Incorporated CurrentSince Sep 1, 2020 Accepting new patients

Locations

631 S Brookhurst St
Ste 101
Anaheim, CA 92804
Phone (714) 991-5700

Interoperability endpoints

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

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": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1174991954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021006",
            "telephone_number": "562-698-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021006",
            "telephone_number": "562-698-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "DAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-10",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.