Provider Demographics
NPI:1043471758
Name:NGUYEN-LE, TRANG QUYNH (DO)
Entity Type:Individual
Prefix:DR
First Name:TRANG
Middle Name:QUYNH
Last Name:NGUYEN-LE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TRANG
Other - Middle Name:QUYNH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2545 S BRUCE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-1778
Mailing Address - Country:US
Mailing Address - Phone:702-732-2438
Mailing Address - Fax:
Practice Address - Street 1:861 CORONADO CENTER DR STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3992
Practice Address - Country:US
Practice Address - Phone:702-726-6344
Practice Address - Fax:702-726-5828
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1801207RN0300X
MI5101017719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1043471758Medicaid
AZ861718Medicaid
AZ861718Medicaid
NVV109459Medicare PIN
AZ861718Medicaid
NVV106366Medicare PIN