Individual provider Active NPI

Lam Q. Le, PA-C

  • Surgical Physician Assistant
  • Merced, CA
National Provider Identifier
1164824066
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA51946 Issued in CA
Practice address
388 E Yosemite Ave Ste 100
Merced, CA 95340-8219
Phone
(209) 722-7801
NPI assigned
Sep 23, 2014
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51946 CA
Surgical Physician Assistant 363AS0400X PA51946 CA Primary

Addresses

Primary practice location

388 E Yosemite Ave Ste 100
Merced, CA 95340-8219

Mailing address

63 Tampico CT
Bay Point, CA 94565-7660
Phone (925) 207-4601

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
I20150105001468 CA Practitioner - Physician Assistant 0840513537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 Central Blvd
Suite D
Brentwood, CA 94513-2227
Phone (925) 308-9510

1324 Nelson Ave
Modesto, CA 95350-5374
Phone (209) 524-9481

2255 Ygnacio Valley Rd
Suite B1
Walnut Creek, CA 94598-3335
Phone (925) 945-7005

355 Lennon LN
Suite 255
Walnut Creek, CA 94598-2496
Phone (925) 932-7704

388 E Yosemite Ave
Suite 100
Merced, CA 95340-8219
Phone (209) 722-7801

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51946CAMDPharmacist
PA51946CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Oct 4, 2019 Accepting new patients
Luminous Dermatology CurrentSince Oct 1, 2017 Accepting new patients
California Skin Institute, a Medical Corporation Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Dermatology Affiliates Medical Group a Professional Corporation PastSince Jun 25, 2019 Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

388 E Yosemite Ave
Ste 100
Merced, CA 95340
Phone (209) 383-3456

1324 Nelson Ave
Ste B
Modesto, CA 95350
Phone (209) 524-9481

504 W Pueblo St
Ste 102
Santa Barbara, CA 93105
Phone (805) 682-3329

2255 Ygnacio Valley Rd
Ste B1
Walnut Creek, CA 94598
Phone (925) 945-7005

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1164824066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 TAMPICO CT",
            "city": "BAY POINT",
            "state": "CA",
            "postal_code": "945657660",
            "telephone_number": "925-207-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 E YOSEMITE AVE STE 100",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953408219",
            "telephone_number": "209-722-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "LAM",
        "middle_name": "Q.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51946",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA51946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.