Individual provider Active NPI

Tram Bao Le, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1346442985
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A105829 Issued in CA
Practice address
5507 El Cajon Blvd
L
San Diego, CA 92115-3624
Phone
(619) 286-2789
Fax
(619) 265-2070
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A105829 CA Primary

Addresses

Primary practice location

5507 El Cajon Blvd
L
San Diego, CA 92115-3624

Mailing address

5507 El Cajon Blvd
L
San Diego, CA 92115-3624
Phone (619) 286-2789

Other identifiers 1

IdentifierTypeStateIssuer
1346442985OtherCA1346442985

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
I20091217000666 CA Practitioner - Family Practice 3971643214 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5507 El Cajon Blvd
Suite L
San Diego, CA 92115-3624
Phone (619) 286-2789

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A105829CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlynne Medical Associates,PC PastSince Jul 1, 2001 Accepting new patients
Scripps Health Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1346442985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5507 EL CAJON BLVD",
            "address_2": "L",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153624",
            "telephone_number": "619-286-2789",
            "fax_number": "619-265-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5507 EL CAJON BLVD",
            "address_2": "L",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153624",
            "telephone_number": "619-286-2789",
            "fax_number": "619-265-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "TRAM",
        "middle_name": "BAO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A105829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1346442985",
            "identifier": "1346442985",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.