Healthcare Provider Details

I. General information

NPI: 1144672585
Provider Name (Legal Business Name): ISABELLA LE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MISSION ST
SAN FRANCISCO CA
94110-2415
US

IV. Provider business mailing address

664 KAULANA PL
HONOLULU HI
96821-2533
US

V. Phone/Fax

Practice location:
  • Phone: 408-493-5135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number703523
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number82176
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95008065
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: