NPIMap

Individual provider Active NPI

Tam Canh Le, MD

  • Internal Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1336381607
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A117637 Issued in CA
Practice address
9746 Westminster Ave
Suite D3
Garden Grove, CA 92844-2984
Phone
(714) 643-9442
Fax
(714) 643-9441
NPI assigned
Apr 1, 2009
Last updated
Jun 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14412 NV
Internal Medicine Physician 207R00000X A117637 CA Primary

Addresses

Primary practice location

9746 Westminster Ave
Suite D3
Garden Grove, CA 92844-2984

Mailing address

15521 Sunburst LN
Huntington Beach, CA 92647-2942
Phone (714) 643-9442

Other identifiers 2

IdentifierTypeStateIssuer
1336381607MedicaidNV
12410527OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000364 CA Practitioner - Internal Medicine 6103082920 Reassigns benefits to 2 organizations
Practice locations: Garden Grove, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9746 Westminster Ave
Suite D3
Garden Grove, CA 92844-2984
Phone (714) 643-9442

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A117637CAMDInternal Medicine Physician
14412NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Internal Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 30, 2013 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 30, 2013 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
University of California Irvine Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Ky Ngoc Nguyen MD Inc PastSince Sep 7, 2021 Accepting new patients
S Pannu Inc Internal Medicine Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

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": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1336381607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15521 SUNBURST LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472942",
            "telephone_number": "714-643-9442",
            "fax_number": "714-643-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9746 WESTMINSTER AVE",
            "address_2": "SUITE D3",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928442984",
            "telephone_number": "714-643-9442",
            "fax_number": "714-643-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "TAM",
        "middle_name": "CANH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "14412",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A117637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336381607",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12410527",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.