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General NPI Number Information
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NPI Number | 1629680665
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Entity Type | Organization
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Legal Business Name | ANDY LE MD INC
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 18111 BROOKHURST ST STE 3200
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6728
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Country | US
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Telephone | 714-369-1100
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Fax | 714-464-4645
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Provider Business Mailing Address
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Address Line | PO BOX 25033
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City | SANTA ANA
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State | CA
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Zip | 92799-5033
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Country | US
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Telephone | 714-347-1000
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Fax | 714-647-1243
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDY LE
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Credential |
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Telephone | 714-865-9616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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