Provider Demographics
NPI:1902986664
Name:LE, HUAN D (MD)
Entity Type:Individual
Prefix:
First Name:HUAN D
Middle Name:
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HUAN
Other - Middle Name:D
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60426
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-6014
Mailing Address - Country:US
Mailing Address - Phone:714-544-9893
Mailing Address - Fax:
Practice Address - Street 1:15355 BROOKHURST ST STE 102
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-7071
Practice Address - Country:US
Practice Address - Phone:714-775-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000000G59923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G599230Medicaid
CAWG59923KMedicare PIN
CA00G599230Medicaid