Organization Active NPI

Dr Tran Plastic Surgery

  • Plastic Surgery Physician
  • Walnut Creek, CA
National Provider Identifier
1336989128
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
DR TRAN PLASTIC SURGERY
Practice address
2637 Shadelands Dr Ste G
Walnut Creek, CA 94598-2512
Phone
(925) 914-8042
Fax
(925) 753-1986
NPI assigned
May 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Bao Ngoc Tran, MDNPI 1528478799
Title
Owner
Phone
(925) 914-8042

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

2637 Shadelands Dr Ste G
Walnut Creek, CA 94598-2512

Mailing address

2637 Shadelands Dr Ste G
Walnut Creek, CA 94598-2512
Phone (925) 914-8042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250121000697 CA Part B Supplier - Clinic/Group Practice 0941739932 Receives reassigned benefits from 1 practitioner
Practice locations: Walnut Creek, CA

National Provider Directory

National Provider Directory

Locations

2637 Shadelands Dr
Ste G
Walnut Creek, CA 94598
Phone (925) 914-8042

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1336989128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 SHADELANDS DR STE G",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-914-8042",
            "fax_number": "925-753-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 SHADELANDS DR STE G",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-914-8042",
            "fax_number": "925-753-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TRAN PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "BAO NGOC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-914-8042",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.