Active NPI
Bao Lam, M.D.
- Hematology & Oncology Physician
- San Leandro, CA
National Provider Identifier
1639354970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- A116762
- Practice address
- 13847 E 14TH St
Suite #217
San Leandro, CA 94578-2632 - Phone
- (510) 483-2555
- Fax
- (510) 483-1856
- NPI assigned
- Jan 7, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | A116762 | CA | Primary |
Addresses
Primary practice location
13847 E 14TH St
Suite #217
San Leandro, CA 94578-2632
Mailing address
4721 Dallas Ranch Road
Antioch, CA 94531-8811
Phone (925) 778-0679
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1639354970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4721 DALLAS RANCH ROAD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318811",
"telephone_number": "925-778-0679",
"fax_number": "925-778-3568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13847 E 14TH ST",
"address_2": "SUITE #217",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945782632",
"telephone_number": "510-483-2555",
"fax_number": "510-483-1856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "BAO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-07",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "CA",
"license": "A116762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.