Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A97634 | CA |
NPI | 1003028416 |
---|---|
Provider Name | Dr. Crystal Nguyen Le |
First Address | San Diego, CA 92123 |
Second Address | San Diego, CA 92123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2007 |
Last Update Date | 06/04/2011 |