Healthcare Provider Details

I. General information

NPI: 1750840278
Provider Name (Legal Business Name): THOMAS TRUNG THANH LE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 E 4TH ST
SANTA ANA CA
92705-3804
US

IV. Provider business mailing address

140 S FLOWER ST STE 100
ORANGE CA
92868-3467
US

V. Phone/Fax

Practice location:
  • Phone: 714-683-5876
  • Fax:
Mailing address:
  • Phone: 714-683-5876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: