Individual provider Active NPI

Thao Dieu Tran

  • Family Nurse Practitioner
  • Garden Grove, CA
National Provider Identifier
1346715661
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95008576 Issued in CA
Practice address
9191 Westminster Ave Ste 207
Garden Grove, CA 92844-2751
Phone
(714) 786-5794
NPI assigned
Oct 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95008576 CA Primary

Addresses

Primary practice location

9191 Westminster Ave Ste 207
Garden Grove, CA 92844-2751

Mailing address

9191 Westminster Ave Ste 207
Garden Grove, CA 92844-2751
Phone (714) 786-5794

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
I20190117003736 CA Practitioner - Nurse Practitioner 5294071833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95008576CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saetrum Opgaard MD Inc CurrentSince Oct 30, 2018 Accepting new patients

Locations

9191 Westminster Ave
Ste 207
Garden Grove, CA 92844
Phone (714) 786-5794

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.

NPI Registry JSON

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

{
    "created_epoch": "1539388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1346715661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 WESTMINSTER AVE STE 207",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928442751",
            "telephone_number": "714-786-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 WESTMINSTER AVE STE 207",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928442751",
            "telephone_number": "714-786-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "THAO",
        "middle_name": "DIEU",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-13",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95008576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.