Individual provider Active NPI

Phet Tran

  • Primary Care Nurse Practitioner
  • Chino, CA
National Provider Identifier
1477329944
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95027932 Issued in CA
Practice address
5562 Philadelphia St Ste 301
Chino, CA 91710-2499
Phone
(214) 868-4371
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95027932 CA
Gerontology Nurse Practitioner 363LG0600X 95027932 CA
Primary Care Nurse Practitioner 363LP2300X 95027932 CA Primary

Addresses

Primary practice location

5562 Philadelphia St Ste 301
Chino, CA 91710-2499

Mailing address

2 Koret Way
San Francisco, CA 94143-2218

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
I20241204001570 CA Practitioner - Nurse Practitioner 6507392354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North East Medical ServicesGroup PAC ID 4284520529, 143 clinicians

Practice addresses (Care Compare)

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95027932CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North East Medical Services CurrentSince Nov 25, 2024 Accepting new patients
North East Medical Services CurrentSince Nov 25, 2024 Accepting new patients
North East Medical Services Current Accepting new patients
Officemd, a Medical Corporation Past Accepting new patients

Locations

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

Organizations & group practices 4

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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1477329944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 KORET WAY",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST STE 301",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102499",
            "telephone_number": "214-868-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PHET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95027932",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95027932",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95027932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.