Individual provider Active NPI

Tai Tran, P.A.

  • Physician Assistant
  • Stockton, CA
National Provider Identifier
1750445193
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13685 Issued in CA
Practice address
701 E Channel St
Stockton, CA 95202-2628
Phone
(209) 944-4700
Fax
(209) 944-4795
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13685 CA Primary

Addresses

Primary practice location

701 E Channel St
Stockton, CA 95202-2628

Mailing address

PO Box 779
Stockton, CA 95201-0779
Phone (209) 373-2800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040830000634 CA Practitioner - Physician Assistant 6406821826 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13685CAMDCorneal and Contact Management Optometrist
PA13685CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Centers, Inc. CurrentSince Jun 13, 2010 Accepting new patients
Community Medical Centers, Inc. Current Accepting new patients
Community Medical Centers Inc CurrentSince Jun 13, 2010 Accepting new patients

Locations

701 E Channel St
Stockton, CA 95202
Phone (209) 944-4700

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

Interoperability endpoints

  • Direct secure messaging: ttran768686@direct.ochin.org
  • Direct secure messaging: tai.tran.p1@direct.cmcentersinc.nextgenshare.com

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1750445193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952010779",
            "telephone_number": "209-373-2800",
            "fax_number": "209-373-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E CHANNEL ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022628",
            "telephone_number": "209-944-4700",
            "fax_number": "209-944-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TAI",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.