Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A80706 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | A80706 | CA |
NPI | 1083707251 |
---|---|
Provider Name | Loc T Le |
First Address | Emeryville, CA 94608 |
Second Address | Pleasanton, CA 94855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 19/11/2012 |