MEDICARE: MINH LE M.D.

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	A72624	CA

General Provider Information

NPI Number	:	1700999414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINH LE M.D.

Provider Business Mailing Address
First Line	:	25 N 14TH ST
Second Line	:	SUITE 700
City	:	SAN JOSE
State	:	CA
Zip	:	95112-6214
Country	:	US
Telephone Number	:	408-971-1150
Fax Number	:	408-971-1151

Provider Business Practice Location Address
First Line	:	25 N 14TH ST
Second Line	:	SUITE 700
City	:	SAN JOSE
State	:	CA
Zip	:	95112-6214
Country	:	US
Telephone Number	:	408-971-1150
Fax Number	:	408-971-1151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	01/26/2011

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