PHUONG THI KIM TRAN PA-C
NPI 1063532232
Physician Assistant - Medical in San Diego, CA

Q: What is Phuong Tran's NPI number?

The NPI number for Phuong Tran is 1063532232. It was assigned to this individual provider in the NPPES registry on March 30, 2007.

Q: What is Phuong Tran's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Phuong Tran was last updated on October 27, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 30, 2007PECOS Enrolled

6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121(858) 859-1188 Get Directions Write a Review

NPPES record last updated: October 27, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 27, 2022, May 6, 2019, Feb 21, 2018 and 1 more (4 updates tracked since 2016).

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About Phuong Thi Kim Tran Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHUONG THI KIM TRAN PA-C (NPI 1063532232) is an individual medical provider in San Diego, California, licensed in California (PA 18370) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063532232

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NamePHUONG THI KIM TRANCredential: PA-C

Location Address6195 LUSK BLVD STE 250San Diego, CA 92121-3715

Mailing Address10444 Flanders CvSan Diego, CA 92126-3031

Phone(858) 859-1188

Sole ProprietorNo

Enumeration DateMarch 30, 2007

Last NPPES UpdateOctober 27, 20224 updates tracked since enumeration

NPPES CertifiedOctober 27, 2022

✔ NPI 1063532232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · PA 18370

6195 LUSK BLVD STE 250, San Diego, CA 92121

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phuong Thi Kim Tran Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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