MEDICARE: DAN LE CARDIOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207UN0901X	Nuclear Cardiology Physician
2	207RI0011X	Interventional Cardiology Physician
3	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1063096477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAN LE CARDIOLOGY

Provider Business Mailing Address
First Line	:	PO BOX 20259
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92728-0259
Country	:	US
Telephone Number	:	714-714-0075
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 BOLSA AVE UNIT P
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-5943
Country	:	US
Telephone Number	:	714-714-0075
Fax Number	:	833-699-2097

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. DAN LE
Credential	:	MD
Telephone Number	:	714-714-0075

Provider Enumeration Date	:	05/11/2021
Last Update Date	:	05/11/2021

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Directions to “DAN LE CARDIOLOGY ” Practice Location

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