Individual provider Active NPI

Khanh Tran, MD

  • Emergency Medicine Physician
  • Huntington Beach, CA
National Provider Identifier
1225055742
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A062648 Issued in CA
Practice address
17772 Beach Blvd
Huntington Beach, CA 92647
Phone
(714) 842-1473
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A062648 CA Primary

Addresses

Primary practice location

17772 Beach Blvd
Huntington Beach, CA 92647

Mailing address

PO Box 10690
Westminster, CA 92685
Phone (562) 809-3554

Other identifiers 1

IdentifierTypeStateIssuer
00A626480MedicaidCA

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
I20041208000416 CA Practitioner - Emergency Medicine 2365408622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A062648CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients
Huntington Beach Medical Group Past Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

22855 Lake Forest Dr
Ste A
Lake Forest, CA 92630
Phone (949) 452-7544

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Interoperability endpoints

  • Direct secure messaging: ktran17427@direct.memorialcare.org

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225055742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10690",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "92685",
            "telephone_number": "562-809-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17772 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92647",
            "telephone_number": "714-842-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KHANH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A062648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A626480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.