Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MT213923 | CA |
N | 207R00000X | Internist | MT213923 | PA |
N | 111NI0900X | Internist | MT213923 | PA |
NPI | 1003345737 |
---|---|
Provider Name | Stephanie T Le |
First Address | Sacramento, CA 95816-3367 |
Second Address | Sacramento, CA 95816-3367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2017 |
Last Update Date | 12/09/2018 |