| Tuan Dai Le, M.d, A Professional Corporation | |
|
1151 E Holt Ave Suite Q Pomona CA 91767-5813 | |
| (909) 620-8436 | |
| (909) 868-5134 |
| Full Name | Tuan Dai Le, M.d, A Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1151 E Holt Ave, Pomona, California |
| Authorized Official Name and Position | Tuan Dai Le (OWNER) |
| Authorized Official Contact | 9096208436 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tuan Dai Le, M.d, A Professional Corporation 1151 E Holt Ave Suite Q Pomona CA 91767-5813 Ph: (909) 620-8436 | Tuan Dai Le, M.d, A Professional Corporation 1151 E Holt Ave Suite Q Pomona CA 91767-5813 Ph: (909) 620-8436 |
| NPI Number | 1205017035 |
|---|---|
| Provider Enumeration Date | 11/20/2007 |
| Last Update Date | 06/25/2014 |
| Medicare PECOS PAC ID | 9638249329 |
|---|---|
| Medicare Enrollment ID | O20080606000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205017035 | NPI | - | NPPES |
| 00A600321 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A60032 (California) | Primary |
| Provider Name | Tuan D Le |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1528243359 PECOS PAC ID: 8022027028 Enrollment ID: I20060419000831 |
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