Individual provider Active NPI

Mike Trung-Hung Vu Tran, MD

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
National Provider Identifier
1205155371
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A121851 Issued in CA
Practice address
11301 Wilshire Blvd
Dept of PM&R, Room 117
Los Angeles, CA 90073-1003
Phone
(617) 903-8904
NPI assigned
May 27, 2010
Last updated
Apr 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MA
Student in an Organized Health Care Education/Training Program 390200000X CA
Physical Medicine & Rehabilitation Physician 208100000X A121851 CA Primary

Addresses

Primary practice location

11301 Wilshire Blvd
Dept of PM&R, Room 117
Los Angeles, CA 90073-1003

Mailing address

11301 Wilshire Blvd
Dept of PM&R, Room 117
Los Angeles, CA 90073-1003
Phone (617) 903-8904

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
I20140621000067 CA Practitioner - Physical Medicine and Rehabilitation 0244454890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9475 Heil Ave
Suite D
Fountain Valley, CA 92708-2258
Phone (714) 775-7700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A121851CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Van Huy Vu, MD, Inc. CurrentSince May 1, 2014 Accepting new patients
Mike Hung Tran, M.D. Inc Past Accepting new patients

Locations

9475 Heil Ave
Ste D
Fountain Valley, CA 92708
Phone (714) 775-1144

16541 Brookhurst St
Fountain Vly, CA 92708
Phone (714) 775-7700

16787 Beach Blvd
Huntington Beach, CA 92647
Phone (657) 204-6014

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1205155371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "address_2": "DEPT OF PM&R, ROOM 117",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "617-903-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "address_2": "DEPT OF PM&R, ROOM 117",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "617-903-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MIKE TRUNG-HUNG",
        "middle_name": "VU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A121851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.