Provider Demographics
NPI:1346442985
Name:LE, TRAM BAO (MD)
Entity Type:Individual
Prefix:
First Name:TRAM
Middle Name:BAO
Last Name:LE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5507 EL CAJON BLVD
Mailing Address - Street 2:L
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-3624
Mailing Address - Country:US
Mailing Address - Phone:619-286-2789
Mailing Address - Fax:619-265-2070
Practice Address - Street 1:5507 EL CAJON BLVD
Practice Address - Street 2:L
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-3624
Practice Address - Country:US
Practice Address - Phone:619-286-2789
Practice Address - Fax:619-265-2070
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2016-02-17
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Provider Licenses
StateLicense IDTaxonomies
CAA105829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1346442985Other1346442985
CA1346442985Medicare PIN