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NPI Code Detail

MEDICARE: SUSAN P. LE MD

MEDICARE: SUSAN P. LE MD
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA89810CA

General Provider Information

NPI Number : 1073691572
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN P. LE MD
Provider Business Mailing Address
First Line : 4021 THORNHILL WAY
Second Line :
City : MODESTO
State : CA
Zip : 95356-9351
Country : US
Telephone Number : 209-667-1718
Fax Number :
Provider Business Practice Location Address
First Line : 2010 COLORADO AVE
Second Line :
City : TURLOCK
State : CA
Zip : 95382-2002
Country : US
Telephone Number : 209-667-1718
Fax Number : 209-667-1719
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 09/08/2020

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