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NPI Code Detail

MEDICARE: KHANH V LE M D A PROFESSIONAL CORPORATION

MEDICARE: KHANH V LE M D A PROFESSIONAL CORPORATION
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
1207R00000XInternal Medicine Physician10417NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356371538
Entity Type Code : Organization
Provider Name (Legal Business Name) : KHANH V LE M D A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 309 ONYX CREST ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-8710
Country : US
Telephone Number : 702-453-3799
Fax Number : 702-453-5741
Provider Business Practice Location Address
First Line : 657 N TOWN CENTER DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-6367
Country : US
Telephone Number : 702-453-3799
Fax Number : 702-453-5741
Authorized Official
Title or Position : PHYSICIAN
Name : KHANH V LE
Credential : M.D.
Telephone Number : 702-281-1379
Provider Enumeration Date : 07/04/2006
Last Update Date : 10/06/2014

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Directions to “KHANH V LE M D A PROFESSIONAL CORPORATION ” Practice Location

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