Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | A87631 | CA |
NPI | 1093810699 |
---|---|
Provider Name | Tam Hoang Le |
First Address | Long Beach, CA 90806-2774 |
Second Address | Long Beach, CA 90806-2774 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 21/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A876310 | (05) | CA |
C70827 | (02) | CA |
ZZZ82334Z | (05) | CA |