Healthcare Provider Details

I. General information

NPI: 1689596538
Provider Name (Legal Business Name): MJ MEDICAL & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
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: 626-765-7686
  • Fax: 562-371-0062
Mailing address:
  • Phone: 626-765-7686
  • Fax: 562-371-0062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL B LE
Title or Position: PRESIDENT
Credential: MD
Phone: 626-765-7686