MEDICARE: DUNG Q LE MD

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	207W00000X	Ophthalmology Physician	A79927	CA

General Provider Information

NPI Number	:	1861594137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUNG Q LE MD

Provider Business Mailing Address
First Line	:	36921 COOK ST STE 103
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-6070
Country	:	US
Telephone Number	:	760-836-3937
Fax Number	:	760-836-1151

Provider Business Practice Location Address
First Line	:	36921 COOK ST
Second Line	:	SUITE 103
City	:	PALM DESERT
State	:	CA
Zip	:	92211-6070
Country	:	US
Telephone Number	:	760-836-3937
Fax Number	:	760-836-1151

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

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	03/11/2015

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1356520241 — DUNG Q LE MD A PROFESSIONAL CORPORATION
Practice Location Address:

36921 COOK ST , SUITE 103
PALM DESERT, CA
92211-6070

Practice Phone: 760-836-3937
Practice Fax: 760-836-1151

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