St. Paul Medical Clinic a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A90428 Issued in CA

Legal business name

ST. PAUL MEDICAL CLINIC A PROFESSIONAL CORPORATION

Practice address

15216 Vanowen St Ste 2a
Van Nuys, CA 91405-3679

Phone

(818) 989-2406

Fax

(818) 989-0696

NPI assigned

Nov 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Anhtuan Dang Tran, M.D.NPI 1518961846

Title

President

Phone

(818) 989-2406

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anhtuan D. Tran, MD.

  • Internal Medicine Physician
  • Van Nuys, CA
  • NPI 1518961846
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1163808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1629142062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15216 VANOWEN ST STE 2A",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053679",
            "telephone_number": "818-989-2406",
            "fax_number": "818-989-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15216 VANOWEN ST STE 2A",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053679",
            "telephone_number": "818-989-2406",
            "fax_number": "818-989-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PAUL MEDICAL CLINIC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-18",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "ANHTUAN",
        "authorized_official_middle_name": "DANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-989-2406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A90428",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A90428",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A904280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. John's Healthcare Services
• St. Jude Home Health Care
• St. Lilly Hospice, Inc.
• St. Luke's Hospice Agency
• St. Mary's Hospice and Palliative Care, Inc.
• St. Peter's Hospice Care, Inc.
• St. Peter's Place
• St. Raphael Archangel Home Health Care Inc
• St. Rita's Congregate, Inc.
• St. Theresa Home Health, Inc.

• Internal Medicine Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.