Active NPI
Khiem Tran, M.P.T.
- Physical Therapist
- Brea, CA
National Provider Identifier
1255359691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 27904
- Practice address
- 381 Cedar Ave
Brea, CA 92821-6602 - Phone
- (949) 274-5342
- Fax
- (951) 699-1145
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 27904 | CA | Primary |
Addresses
Primary practice location
381 Cedar Ave
Brea, CA 92821-6602
Mailing address
43500 Ridge Park Dr
Suite 102
Temecula, CA 92590-3624
Phone (949) 927-5342
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27904 | Other | CA | PHYSICAL THERAPY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27904 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Network Solutions Inc | Physical Therapist | Current | Accepting new patients |
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.
-
- Physical Therapist
- Brea, CA
- NPI 1053125344
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": "1227052800000",
"number": "1255359691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43500 RIDGE PARK DR",
"address_2": "SUITE 102",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925903624",
"telephone_number": "949-927-5342",
"fax_number": "951-699-1145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "381 CEDAR AVE",
"city": "BREA",
"state": "CA",
"postal_code": "928216602",
"telephone_number": "949-274-5342",
"fax_number": "951-699-1145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "KHIEM",
"credential": "M.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2008-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "27904",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY LICENSE",
"identifier": "27904",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.