| Ky Le Llc | |
|
98-1079 Moanalua Rd Aiea HI 96701-4713 | |
| (808) 536-0300 | |
| Not Available |
| Full Name | Ky Le Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 98-1079 Moanalua Rd, Aiea, Hawaii |
| Authorized Official Name and Position | Ky Le (OWNER) |
| Authorized Official Contact | 8083458996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ky Le Llc 95-1092 Paemoku Pl Mililani HI 96789-6524 Ph: () - | Ky Le Llc 98-1079 Moanalua Rd Aiea HI 96701-4713 Ph: (808) 536-0300 |
| NPI Number | 1053906578 |
|---|---|
| Provider Enumeration Date | 03/05/2021 |
| Last Update Date | 04/21/2021 |
| Medicare PECOS PAC ID | 2769882554 |
|---|---|
| Medicare Enrollment ID | O20210616000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053906578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ky H Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073560025 PECOS PAC ID: 7315962206 Enrollment ID: I20051010000940 |
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