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NPI Code Detail

MEDICARE: PHUONG KHANH LE

MEDICARE: PHUONG KHANH LE
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1962890483
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHUONG KHANH LE
Provider Business Mailing Address
First Line : 8745 AERO DR STE 330
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1763
Country : US
Telephone Number : 858-268-4933
Fax Number :
Provider Business Practice Location Address
First Line : 8745 AERO DR STE 330
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1763
Country : US
Telephone Number : 858-268-4933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2015
Last Update Date : 01/06/2015

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Directions to “ PHUONG KHANH LE ” Practice Location

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