Healthcare Provider Details

I. General information

NPI: 1689699316
Provider Name (Legal Business Name): VIET LE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 MEDICAL CENTER DR
WEST HILLS CA
91307-1902
US

IV. Provider business mailing address

210 N TUSTIN AVE
SANTA ANA CA
92705-3807
US

V. Phone/Fax

Practice location:
  • Phone: 818-884-7060
  • Fax:
Mailing address:
  • Phone: 714-347-1010
  • Fax: 714-647-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG73490
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG73490
License Number StateCA

VIII. Authorized Official

Name: DR. VIET LE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-347-1010