Healthcare Provider Details

I. General information

NPI: 1740296425
Provider Name (Legal Business Name): BACH T. LE M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16157 WHITTIER BLVD
WHITTIER CA
90603-2560
US

IV. Provider business mailing address

16157 WHITTIER BLVD
WHITTIER CA
90603-2560
US

V. Phone/Fax

Practice location:
  • Phone: 562-947-8611
  • Fax: 562-947-8614
Mailing address:
  • Phone: 562-947-8611
  • Fax: 562-947-8614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number41940
License Number StateCA

VIII. Authorized Official

Name: DR. BACH TRONG LE
Title or Position: OWNER
Credential: M.D.,
Phone: 562-947-8611