Healthcare Provider Details

I. General information

NPI: 1578251195
Provider Name (Legal Business Name): MICHAEL B LE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 KATELLA AVE
LOS ALAMITOS CA
90720-3309
US

IV. Provider business mailing address

428 MAIN ST STE 101
HUNTINGTON BEACH CA
92648-8143
US

V. Phone/Fax

Practice location:
  • Phone: 562-598-1311
  • Fax:
Mailing address:
  • Phone: 818-400-6989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA205143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: