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General NPI Number Information
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NPI Number | 1609405158
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Entity Type | Individual
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Provider Name | MAI ABE LE
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Gender | Female
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 1333 2ND ST STE 100
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City | SANTA MONICA
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State | CA
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Zip | 90401-4104
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Country | US
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Telephone | 310-550-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 2ND ST STE 100 UNIT 24
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City | SANTA MONICA
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State | CA
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Zip | 90401-4104
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Country | US
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Telephone | 323-608-7910
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | L9662
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License Number State | CA
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