Active NPI
Wynn Medical Center Nephrology
- Nephrology Physician
- Rosemead, CA
National Provider Identifier
1750139580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Legal business name
- WYNN MEDICAL CENTER NEPHROLOGY
- Practice address
- 9120 Valley Blvd
Rosemead, CA 91770-1920 - Phone
- (626) 316-8169
- NPI assigned
- May 7, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Huynh Tran, MD, FACP
- Title
- President/Ceo
- Phone
- (616) 990-0782
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Nephrology Physician | 207RN0300X | Primary |
Addresses
Primary practice location
9120 Valley Blvd
Rosemead, CA 91770-1920
Mailing address
9120 Valley Blvd
Rosemead, CA 91770-1920
Phone (626) 316-8169
Other names 1
- wynn medical center nephrology internal medicine
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Wynn Medical Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic/Center
- Rosemead, CA
- NPI 1801300298
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715040000000",
"number": "1750139580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9120 VALLEY BLVD",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917701920",
"telephone_number": "626-316-8169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9120 VALLEY BLVD",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917701920",
"telephone_number": "626-316-8169"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WYNN MEDICAL CENTER NEPHROLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2024-05-07",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A",
"authorized_official_last_name": "TRAN",
"authorized_official_first_name": "HUYNH",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "616-990-0782",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD, FACP"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "wynn medical center nephrology internal medicine",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Rosemead, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.