Individual provider Active NPI

Bang K Tran, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1396752887
Registry record updated May 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12009T Issued in CA
Practice address
3005 Silver Creek Rd
104
San Jose, CA 95121-1789
Phone
(408) 238-4900
Fax
(408) 238-4903
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12009T CA Primary

Addresses

Primary practice location

3005 Silver Creek Rd
104
San Jose, CA 95121-1789

Mailing address

4713 Hill Top View PL
San Jose, CA 95138-2708
Phone (408) 238-4900

Other identifiers 1

IdentifierTypeStateIssuer
BB610ZMedicaidCA

Other names 1

  • Kalvin B Tran Other name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081220000136 CA Practitioner - Optometry 1355403650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009CAMDChiropractor
12009TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242950400000",
    "number": "1396752887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4713 HILL TOP VIEW PL",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382708",
            "telephone_number": "408-238-4900",
            "fax_number": "408-238-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 SILVER CREEK RD",
            "address_2": "104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211789",
            "telephone_number": "408-238-4900",
            "fax_number": "408-238-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "BANG",
        "middle_name": "K",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2009-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12009T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BB610Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALVIN",
            "last_name": "TRAN",
            "middle_name": "B",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.