Organization Active NPI

Kim-Oanh Thi Tran

  • Community/Retail Pharmacy
  • Westminster, CA
National Provider Identifier
1417125477
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY40306 Issued in CA
Legal business name
KIM-OANH THI TRAN
Doing business as
KIM PHARMACY
Practice address
14536 Brookhurst St
Ste 101
Westminster, CA 92683-5787
Phone
(714) 775-6677
Fax
(714) 775-6595
NPI assigned
Feb 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Kim Oanh TranNPI 1518954684
Title
Owner/Pic
Phone
(714) 775-6677

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY40306 CA Primary

Addresses

Primary practice location

14536 Brookhurst St
Ste 101
Westminster, CA 92683-5787

Mailing address

14536 Brookhurst St
Ste 101
Westminster, CA 92683-5787
Phone (714) 775-6677

Other identifiers 2

IdentifierTypeStateIssuer
PHA403060MedicaidCA
2000758OtherPK

Other names 1

  • KIM PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930008499 CA DME Supplier - Pharmacy 7618098617 Practice locations: Westminster, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Kim Pharmacy14536 Brookhurst St, Westminster, CA 92683-5788(714) 775-6677 Nebulizer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Nebulizer Equipment and/or Supplies Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

14536 Brookhurst St
Ste 101
Westminster, CA 92683
Phone (714) 775-6677

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": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1417125477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14536 BROOKHURST ST",
            "address_2": "STE 101",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835787",
            "telephone_number": "714-775-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14536 BROOKHURST ST",
            "address_2": "STE 101",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835787",
            "telephone_number": "714-775-6677",
            "fax_number": "714-775-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM-OANH THI TRAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "KIM OANH",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "714-775-6677"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY40306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA403060",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2000758",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KIM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westminster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.