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4419 47th St San Diego CA 92115-4516 | |
| (619) 929-1605 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4419 47th St, San Diego, California |
| Authorized Official Name and Position | Charles Nguyen-thanh Le (PRESIDENT) |
| Authorized Official Contact | 6199291605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4419 47th St San Diego CA 92115-4516 Ph: (619) 929-1605 | 4419 47th St San Diego CA 92115-4516 Ph: (619) 929-1605 |
| NPI Number | 1205467073 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 06/19/2021 |
| Certification Date | 06/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205467073 | NPI | - | NPPES |
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