Organization Active NPI

Khang Van Tran M.D., Inc.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1841306016
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KHANG VAN TRAN M.D., INC.
Practice address
4616 El Cajon Blvd
Suite 9
San Diego, CA 92115-4426
Phone
(619) 280-4616
Fax
(619) 280-4617
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Dr. Khang Van Tran, M.D.NPI 1194991430
Title
President
Phone
(619) 280-4616

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4616 El Cajon Blvd
Suite 9
San Diego, CA 92115-4426

Mailing address

4616 El Cajon Blvd
Suite 9
San Diego, CA 92115-4426
Phone (619) 280-4616

Other identifiers 1

IdentifierTypeStateIssuer
A33941MedicaidCA

National Provider Directory

National Provider Directory

Locations

6947 Linda Vista Rd
Ste A
San Diego, CA 92111
Phone (858) 495-0592

4616 El Cajon Blvd
Ste 9
San Diego, CA 92115
Phone (619) 280-4616

4616 El Cajon Blvd
Ste 90
San Diego, CA 92115
Phone (619) 280-4616

Practitioners & affiliated clinicians

Practitioners 1

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": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1841306016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 EL CAJON BLVD",
            "address_2": "SUITE 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154426",
            "telephone_number": "619-280-4616",
            "fax_number": "619-280-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 EL CAJON BLVD",
            "address_2": "SUITE 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154426",
            "telephone_number": "619-280-4616",
            "fax_number": "619-280-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHANG VAN TRAN M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "KHANG",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-280-4616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A33941",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.