Individual provider Active NPI

Thomas Thanh Tran, MD

  • Internal Medicine Physician
  • Corona, CA
National Provider Identifier
1710972997
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A85242 Issued in CA
Practice address
800 S Main St
Corona, CA 92882-3420
Phone
(951) 278-5590
Fax
(951) 272-9924
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A85242 CA
Internal Medicine Physician 207R00000X A85242 CA Primary

Addresses

Primary practice location

800 S Main St
Corona, CA 92882-3420

Mailing address

PO Box 77790
Corona, CA 92877-0126
Phone (951) 278-5590

Other identifiers 1

IdentifierTypeStateIssuer
00A852420OtherCABLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050124000692 CA Practitioner - Internal Medicine 2567412943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians

Practice addresses (Care Compare)

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (909) 883-8711

Hospital & facility affiliations

  • St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A85242CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Mar 1, 2015 Accepting new patients
Cogent Healthcare of California, PC Internal Medicine Past Accepting new patients
Thomas Thanh Tran, M.D., Inc. Internal Medicine Past Accepting new patients
Inland Hospitalists Med GP Internal Medicine Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

155 Glasson Way
Grass Valley, CA 95945
Phone (530) 274-6000

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1710972997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77790",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928770126",
            "telephone_number": "951-278-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823420",
            "telephone_number": "951-278-5590",
            "fax_number": "951-272-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "THOMAS",
        "middle_name": "THANH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A85242",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A85242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A852420",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.