Healthcare Provider Details
I. General information
NPI: 1225229651
Provider Name (Legal Business Name): TRU VAN LE M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2007
Last Update Date: 08/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6404 SEVEN CORNERS PL STE F
FALLS CHURCH VA
22044-2033
US
IV. Provider business mailing address
6404 SEVEN CORNERS PL STE F
FALLS CHURCH VA
22044-2033
US
V. Phone/Fax
- Phone: 703-241-5695
- Fax: 703-237-9896
- Phone: 703-241-5695
- Fax: 702-237-9896
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | VA |
VIII. Authorized Official
Name: DR.
TRU
VAN
LE
Title or Position: OWNER
Credential: M.D.
Phone: 703-241-5695