MEDICARE: MICHAEL LE DO PROFESSIONAL MEDICAL 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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1366398620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL LE DO PROFESSIONAL MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	510 N 13TH AVE STE 306
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91786-4973
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 N 13TH AVE STE 306
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91786-4973
Country	:	US
Telephone Number	:	964-152-2645
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARIAM HANNA
Credential	:
Telephone Number	:	964-152-2645

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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