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General NPI Number Information
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NPI Number | 1114861119
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Entity Type | Individual
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Provider Name | HUONG VAN LE PCC STUDENT
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Gender | Male
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Dates
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Enumeration Date | 04/18/2026
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Last Update Date | 04/18/2026
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Provider Practice Location Address
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Address Line | 2670 S WHITE RD STE 200
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City | SAN JOSE
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State | CA
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Zip | 95148-2073
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Country | US
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Telephone | 408-937-1553
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Fax | 408-516-0053
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Provider Business Mailing Address
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Address Line | 1662 MANOR BLVD
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City | SAN LEANDRO
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State | CA
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Zip | 94579-1509
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Country | US
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Telephone | 510-612-4145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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