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General NPI Number Information
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NPI Number | 1124318522
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Entity Type | Individual
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Provider Name | ISABELLE CHUMFONG LE LEANNEC M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 516 DELAWARE ST SE PWB 11-1145, MMC 195
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 715-222-0980
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Fax |
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Provider Business Mailing Address
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Address Line | 80 BROADWAY ST NE UNIT 305
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-8102
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Country | US
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Telephone | 925-640-8752
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 66148
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A123313
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 306233
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License Number State | NY
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