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General NPI Number Information
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NPI Number | 1578842407
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Entity Type | Organization
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Legal Business Name | VICTOR MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 1001 S. GARFIELD AVE
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City | ALHAMBRA
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State | CA
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Zip | 91801
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Country | US
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Telephone | 714-612-9309
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9195
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92728-9195
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Country | US
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Telephone | 714-612-9309
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VICTOR NGUYEN LE
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Credential | M.D.
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Telephone | 714-612-9309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A111657
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License Number State | CA
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