Healthcare Provider Details

I. General information

NPI: 1932331469
Provider Name (Legal Business Name): RICHARD LE, MD, FCCP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12221 BROOKHURST ST STE 100
GARDEN GROVE CA
92840-2848
US

IV. Provider business mailing address

1119 PINE ST
HUNTINGTON BEACH CA
92648-2736
US

V. Phone/Fax

Practice location:
  • Phone: 714-805-8260
  • Fax: 714-369-6245
Mailing address:
  • Phone: 714-369-4819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA88276
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA88276
License Number StateCA

VIII. Authorized Official

Name: DR. RICHARD DAVID LE
Title or Position: CEO
Credential: MD
Phone: 714-369-4819