Provider Demographics
NPI:1326411000
Name:LE, TRAM (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:TRAM
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79667 MORNING GLORY CT
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4843
Mailing Address - Country:US
Mailing Address - Phone:512-300-8375
Mailing Address - Fax:
Practice Address - Street 1:84010 AVENUE 50
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-9661
Practice Address - Country:US
Practice Address - Phone:760-391-5656
Practice Address - Fax:760-398-6587
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63314183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist