MEDICARE: ANHDAO V. LE, MD INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1134570708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANHDAO V. LE, MD INC.

Provider Business Mailing Address
First Line	:	1024 E PACIFIC COAST HWY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-5017
Country	:	US
Telephone Number	:	562-218-0131
Fax Number	:	562-218-1112

Provider Business Practice Location Address
First Line	:	1024 E PACIFIC COAST HWY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-5017
Country	:	US
Telephone Number	:	562-218-0131
Fax Number	:	562-218-1112

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANHDAO V LE
Credential	:	MD
Telephone Number	:	714-797-2033

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	06/24/2016

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