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General NPI Number Information
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NPI Number | 1629728803
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Entity Type | Individual
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Provider Name | MR. ANTHONY GABRIEL LE
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Gender | Male
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 440 E HUNTINGTON DR STE 311
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City | ARCADIA
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State | CA
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Zip | 91006-3776
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Country | US
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Telephone | 626-209-9804
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Fax |
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Provider Business Mailing Address
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Address Line | 834 MONTECITO DR
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City | SAN GABRIEL
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State | CA
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Zip | 91776-2335
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Country | US
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Telephone | 626-782-9556
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10772
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 129392
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License Number State | CA
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