MEDICARE: DR. RICHARD KIM LE D.O

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	207Q00000X	Family Medicine Physician	4144	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z2107776	OTHER		PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851393003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD KIM LE D.O

Provider Business Mailing Address
First Line	:	3930 S ALMA SCHOOL RD
Second Line	:	SUITE 1
City	:	CHANDLER
State	:	AZ
Zip	:	85248-4510
Country	:	US
Telephone Number	:	480-726-6632
Fax Number	:	480-726-3868

Provider Business Practice Location Address
First Line	:	3930 S ALMA SCHOOL RD
Second Line	:	SUITE 1
City	:	CHANDLER
State	:	AZ
Zip	:	85248-4510
Country	:	US
Telephone Number	:	480-726-6632
Fax Number	:	480-726-3868

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/15/2011

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