Active NPI
Kenneth Duy Tran, OD
- Optometrist
- Berkeley, CA
National Provider Identifier
1699254714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 34030TLG
- Practice address
- 200 Minor Hall UC Berkeley School of Optometry
Berkeley, CA 94720-0001 - Phone
- (510) 642-2020
- NPI assigned
- Aug 9, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 34030TLG | CA | Primary |
Addresses
Primary practice location
200 Minor Hall UC Berkeley School of Optometry
Berkeley, CA 94720-0001
Mailing address
200 Minor Hall UC Berkeley School of Optometry
Berkeley, CA 94720-0001
Phone (510) 642-2020
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34030TLG | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533772800000",
"number": "1699254714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MINOR HALL UC BERKELEY SCHOOL OF OPTOMETRY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947200001",
"telephone_number": "510-642-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MINOR HALL UC BERKELEY SCHOOL OF OPTOMETRY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947200001",
"telephone_number": "510-642-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "KENNETH",
"middle_name": "DUY",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-09",
"last_updated": "2018-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "CA",
"license": "34030TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.