Provider Demographics
NPI:1073560025
Name:LE, KY H (MD)
Entity Type:Individual
Prefix:DR
First Name:KY
Middle Name:H
Last Name:LE
Suffix:
Gender:M
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:PO BOX 998
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91603-0998
Mailing Address - Country:US
Mailing Address - Phone:818-509-2222
Mailing Address - Fax:818-509-2229
Practice Address - Street 1:98-199 KAMEHAMEHA HWY UNIT C-10B
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4821
Practice Address - Country:US
Practice Address - Phone:808-954-4500
Practice Address - Fax:808-758-0146
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 13470207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH100831Medicaid
HI0000256263OtherHMSA
HI57429501Medicaid
HI0000256263OtherHMSA