Individual provider Active NPI

Kevin H Tran, O.D.

  • Optometrist
  • Rancho Cucamonga, CA
National Provider Identifier
1710030911
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12661 Issued in CA
Practice address
9170 Haven Ave Ste 102
Rancho Cucamonga, CA 91730-5416
Phone
(909) 440-1014
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12661 CA Primary

Addresses

Primary practice location

9170 Haven Ave Ste 102
Rancho Cucamonga, CA 91730-5416

Mailing address

14726 Ramona Ave Ste 203
Chino, CA 91710-5730
Phone (626) 305-9100

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041004000620 CA Practitioner - Optometry 5799744033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Azul Vision IncGroup PAC ID 2264851740, 49 clinicians
California Eye Specialists Medical Group IncGroup PAC ID 6800793381, 26 clinicians

Practice addresses (Care Compare)

9170 Haven Ave
Suite 102
Rancho Cucamonga, CA 91730-5416
Phone (909) 440-1014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Eye Specialists Medical Group, Inc CurrentSince Jul 23, 2021 Accepting new patients
Azul Vision Inc. Optometrist CurrentSince Jun 12, 2024 Accepting new patients
Eyecare Specialists Medical Group, Inc Optometrist Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Luxottica of America Inc Past Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

947 S Anaheim Blvd
Ste 120
Anaheim, CA 92805
Phone (714) 821-4666

14726 Ramona Ave
Ste 203
Chino, CA 91710
Phone (626) 305-9100

12442 Limonite Ave
Unit 203
Eastvale, CA 91752
Phone (951) 821-5188

7677 Center Ave
Ste 301
Huntington Beach, CA 92647
Phone (714) 901-2004

81767 Doctor Carreon Blvd
Ste 101
Indio, CA 92201
Phone (760) 342-5268

2600 Redondo Ave
Ste 203
Long Beach, CA 90806
Phone (562) 496-3600

2619 E Colorado Blvd
#150
Pasadena, CA 91107
Phone (626) 305-9100

9170 Haven Ave
Ste 102
Rch Cucamonga, CA 91730
Phone (909) 440-1014

1845 W Redlands Blvd
Ste 101
Redlands, CA 92373
Phone (909) 363-1450

4351 Latham St
#101
Riverside, CA 92501

399 E Highland Ave
Ste 401
Sn Bernrdno, CA 92404
Phone (909) 327-3118

494 N Mountain Ave
Upland, CA 91786
Phone (909) 552-7200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kevin.tran.p1@direct.atlantiseyecare.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 9

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1710030911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14726 RAMONA AVE STE 203",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105730",
            "telephone_number": "626-305-9100",
            "fax_number": "626-305-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9170 HAVEN AVE STE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305416",
            "telephone_number": "909-440-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KEVIN",
        "middle_name": "H",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.