Provider Demographics
NPI:1154480077
Name:LE, TAM M (MD)
Entity Type:Individual
Prefix:DR
First Name:TAM
Middle Name:M
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5825 LINCOLN AVE
Mailing Address - Street 2:STE H
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-3477
Mailing Address - Country:US
Mailing Address - Phone:714-761-1736
Mailing Address - Fax:
Practice Address - Street 1:8905 GARVEY AVE
Practice Address - Street 2:SUITE A5
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-3368
Practice Address - Country:US
Practice Address - Phone:626-757-1494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0070591207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine