Dr Richard T Le, DO | |
12611 Hesperia Rd Ste A, Victorville, CA 92395-8307 | |
(760) 951-7762 | |
(760) 951-7134 |
Full Name | Dr Richard T Le |
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Gender | Male |
Speciality | Dermatology |
Location | 12611 Hesperia Rd Ste A, Victorville, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417070566 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20A12033 (California) | Secondary |
207Q00000X | Family Medicine | N4544 (Texas) | Secondary |
207N00000X | Dermatology | 20A12033 (California) | Primary |
Entity Name | Island Dermatology, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508815556 PECOS PAC ID: 1850395070 Enrollment ID: O20060830000569 |
Mailing Address | Practice Location Address |
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Dr Richard T Le, DO 12611 Hesperia Rd, Ste A, Victorville, CA 92395-8307 Ph: (760) 951-7762 | Dr Richard T Le, DO 12611 Hesperia Rd Ste A, Victorville, CA 92395-8307 Ph: (760) 951-7762 |
Hai T Tran, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 12611 Hesperia Rd, Suite A, Victorville, CA 92395 Phone: 760-951-8714 Fax: 760-951-7134 | |
Liza Gill, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 12565 Hesperia Rd Ste 3, Victorville, CA 92395 Phone: 760-780-0003 Fax: 760-766-1908 | |
Keith Mark Gross, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 12550 Hesperia Rd, 400, Victorville, CA 92395 Phone: 909-335-8638 Fax: 909-335-8644 |