Provider Demographics
NPI:1861517690
Name:LE, TIMOTHY TROUNG
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:TROUNG
Last Name:LE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAI
Other - Middle Name:TROUNG
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1922 THE ALAMEDA STE 316
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1461
Mailing Address - Country:US
Mailing Address - Phone:408-261-7777
Mailing Address - Fax:408-642-6052
Practice Address - Street 1:230 N MORRISON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2741
Practice Address - Country:US
Practice Address - Phone:408-938-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator