NPIMap

Organization Active NPI

Hai Tran, M.D., Inc.

  • Dermatology Physician
  • Victorville, CA
National Provider Identifier
1639366966
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G083905 Issued in CA
Legal business name
HAI TRAN, M.D., INC.
Practice address
12611 Hesperia Rd
Suite a
Victorville, CA 92395-8307
Phone
(760) 951-7762
Fax
(760) 951-7134
NPI assigned
Oct 1, 2007
Last updated
Oct 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Authorized official

Name
Hai Tran, M.D.NPI 1093763104
Title
C.E.O.
Phone
(760) 951-7762

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G083905 CA Primary

Addresses

Primary practice location

12611 Hesperia Rd
Suite a
Victorville, CA 92395-8307

Mailing address

12611 Hesperia Rd
Suite a
Victorville, CA 92395-8307
Phone (760) 951-7762

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080710000795 CA Part B Supplier - Clinic/Group Practice 0840244125 Receives reassigned benefits from 1 practitioner
Practice locations: Victorville, CA

National Provider Directory

National Provider Directory

Locations

12611 Hesperia Rd
Ste A
Victorville, CA 92395
Phone (442) 255-4130

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1639366966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12611 HESPERIA RD",
            "address_2": "SUITE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958307",
            "telephone_number": "760-951-7762",
            "fax_number": "760-951-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12611 HESPERIA RD",
            "address_2": "SUITE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958307",
            "telephone_number": "760-951-7762",
            "fax_number": "760-951-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAI TRAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "HAI",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "760-951-7762",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G083905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.