| Stephanie Phan Le, D.o. Inc. | |
|
1693 Flanigan Dr Ste 100 San Jose CA 95121-1683 | |
| (408) 274-3881 | |
| (408) 274-9053 |
| Full Name | Stephanie Phan Le, D.o. Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1693 Flanigan Dr Ste 100, San Jose, California |
| Authorized Official Name and Position | Stephanie Phan Le (PRESIDENT) |
| Authorized Official Contact | 4082743881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Phan Le, D.o. Inc. 1693 Flanigan Dr Ste 100 San Jose CA 95121-1683 Ph: (408) 274-3881 | Stephanie Phan Le, D.o. Inc. 1693 Flanigan Dr Ste 100 San Jose CA 95121-1683 Ph: (408) 274-3881 |
| NPI Number | 1649610312 |
|---|---|
| Provider Enumeration Date | 06/26/2013 |
| Last Update Date | 05/14/2014 |
| Medicare PECOS PAC ID | 1951524271 |
|---|---|
| Medicare Enrollment ID | O20140514000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649610312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A12311 (California) | Primary |
| Provider Name | Stephanie Phan Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407190093 PECOS PAC ID: 9537384078 Enrollment ID: I20140625002299 |
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