Provider Demographics
NPI:1376575985
Name:TRAM, THONG D (DO)
Entity Type:Individual
Prefix:
First Name:THONG
Middle Name:D
Last Name:TRAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CREEKSIDE DR
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3444
Mailing Address - Country:US
Mailing Address - Phone:916-984-4948
Mailing Address - Fax:916-984-4928
Practice Address - Street 1:1600 CREEKSIDE DR
Practice Address - Street 2:SUITE 2800
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3444
Practice Address - Country:US
Practice Address - Phone:916-984-4948
Practice Address - Fax:916-984-4928
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7856207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX78560Medicaid
CA020A78561Medicare ID - Type Unspecified
CAH56030Medicare UPIN