Healthcare Provider Details

I. General information

NPI: 1811638547
Provider Name (Legal Business Name): CALVIN M. LE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CIRCLE OF HOPE DR RM LL376
SALT LAKE CITY UT
84112-5550
US

IV. Provider business mailing address

2000 CIRCLE OF HOPE DR RM LL376
SALT LAKE CITY UT
84112-5550
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-0255
  • Fax:
Mailing address:
  • Phone: 801-585-0255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number14278959-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD61570677
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: