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General NPI Number Information
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NPI Number | 1073689014
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Entity Type | Organization
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Legal Business Name | CYNTHIA LE
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 1310 BISON AVE
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-9070
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Country | US
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Telephone | 949-760-0363
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Fax |
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Provider Business Mailing Address
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Address Line | 3 CLOCKTOWER
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City | IRVINE
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State | CA
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Zip | 92620-3545
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Country | US
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Telephone | 714-624-1270
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CYNTHIA P. LE
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Credential | D.D.S.
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Telephone | 714-624-1270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | CA
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