Active NPI
Ngan K Tran, PA-C
- Medical Physician Assistant
- San Jose, CA
National Provider Identifier
1508110065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 22668
- Practice address
- 1047 E Capitol Expy
San Jose, CA 95121-2415 - Phone
- (408) 754-8988
- NPI assigned
- Nov 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 22668 | CA | |
| Medical Physician Assistant | 363AM0700X | 22668 | CA | Primary |
Addresses
Primary practice location
1047 E Capitol Expy
San Jose, CA 95121-2415
Mailing address
1047 E Capitol Expy
San Jose, CA 95121-2415
Phone (669) 225-5655
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457439572 | Medicaid | CA | |
| 1457439572 | Other | CA | MEDICARE GROUP NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22668 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494460800000",
"number": "1508110065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1047 E CAPITOL EXPY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951212415",
"telephone_number": "669-225-5655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1047 E CAPITOL EXPY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951212415",
"telephone_number": "408-754-8988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "NGAN",
"middle_name": "K",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-06",
"last_updated": "2017-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "22668",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "22668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457439572",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NPI",
"identifier": "1457439572",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.