Individual provider Active NPI

Bao Lam, M.D.

  • Hematology & Oncology Physician
  • San Leandro, CA
National Provider Identifier
1639354970
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A116762 Issued in CA
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

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.