Individual provider Active NPI

Audrey Phuonganh Tran, DO

  • Internal Medicine Physician
  • Riverside, CA
National Provider Identifier
1972253565
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A21941 Issued in CA
Practice address
4445 Magnolia Ave
Riverside, CA 92501-4199
Phone
(951) 786-5350
NPI assigned
Mar 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A21941 CA Primary

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4199

Mailing address

4445 Magnolia Ave
Riverside, CA 92501-4199
Phone (951) 786-5350

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
I20251125000974 CA Practitioner - Internal MedicinePractitioner - Hospitalist 1658863816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Medical Group of Southern CaliforniaGroup PAC ID 3779921952, 10 clinicians

Practice addresses (Care Compare)

4445 Magnolia Ave
Riverside, CA 92501-4135
Phone (951) 788-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21941CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Medical Group of Southern California Internal Medicine CurrentSince Aug 8, 2025 Accepting new patients

Locations

8816 Foothill Blvd
#103338
Rch Cucamonga, CA 91730

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

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

Organizations & group practices 1

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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1972253565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014199",
            "telephone_number": "951-786-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014199",
            "telephone_number": "951-786-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "AUDREY",
        "middle_name": "PHUONGANH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A21941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.