Individual provider Active NPI

Camthuy Quang Tran, MD

  • Neurology Physician
  • Los Angeles, CA
National Provider Identifier
1730379371
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A93494 Issued in CA
Practice address
300 Medical Plaza
Suite B-200
Los Angeles, CA 90095-0001
Phone
(310) 825-6181
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A93494 CA Primary

Addresses

Primary practice location

300 Medical Plaza
Suite B-200
Los Angeles, CA 90095-0001

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other identifiers 1

IdentifierTypeStateIssuer
00A934940MedicaidCA

Other names 1

  • Ms. Camthuy Quang Tran Professional name

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
I20090725000003 CA Practitioner - Neurology 7719030667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

393 E Walnut St
Pasaden, CA 91188-0001
Phone (877) 608-0044

393 E Walnut St 3Rd FL
Pasadena, CA 91188-0001

4405 Vandever Ave
San Diego, CA 92120-3315
Phone (619) 516-6606

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93494CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 22, 2010 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 22, 2010 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 3

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1730379371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLAZA",
            "address_2": "SUITE B-200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "CAMTHUY",
        "middle_name": "QUANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A93494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A934940",
            "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": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAMTHUY",
            "last_name": "TRAN",
            "middle_name": "QUANG",
            "prefix": "MS.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.