Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 21737 | CA |
NPI | 1609192400 |
---|---|
Provider Name | Dr. Dat Vinh Le |
First Address | Van Nuys, CA 91401 |
Second Address | Van Nuys, CA 91401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 19/04/2010 |