Provider Demographics
NPI:1043252943
Name:LE, ANNIE VO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:VO
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1983 RIO BONITO DR
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-4112
Mailing Address - Country:US
Mailing Address - Phone:626-290-1714
Mailing Address - Fax:
Practice Address - Street 1:1008 E GARVEY AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-3031
Practice Address - Country:US
Practice Address - Phone:626-290-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74521207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14-1964053OtherEIN
CAH89718Medicare UPIN