Organization Active NPI

Tam H. Le, MD Inc.

  • Specialist
  • Fountain Valley, CA
National Provider Identifier
1770544652
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G59425 Issued in CA
Legal business name
TAM H. LE, MD INC.
Practice address
18225 Brookhurst St Ste 1
Fountain Valley, CA 92708-6719
Phone
(714) 861-4560
Fax
(714) 861-4566
NPI assigned
Mar 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Authorized official

Name
Mr. Tam Huu Le, MDNPI 1699770370
Title
Provider
Phone
(714) 861-4560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G59425 CA Primary

Addresses

Primary practice location

18225 Brookhurst St Ste 1
Fountain Valley, CA 92708-6719

Mailing address

18111 Brookhurst St
2600
Fountain Valley, CA 92708-6728
Phone (714) 861-4560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041014000633 CA Part B Supplier - Clinic/Group Practice 4284694126 Receives reassigned benefits from 4 practitioners
Practice locations: Fountain Valley, CA

National Provider Directory

National Provider Directory

Locations

10760 Warner Ave
Ste 101
Fountain Vly, CA 92708
Phone (714) 593-5356

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1770544652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST",
            "address_2": "2600",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-861-4560",
            "fax_number": "714-861-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18225 BROOKHURST ST STE 1",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086719",
            "telephone_number": "714-861-4560",
            "fax_number": "714-861-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAM H. LE, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-30",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "TAM",
        "authorized_official_middle_name": "HUU",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "714-861-4560",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G59425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.