Provider Demographics
NPI:1083707251
Name:LE, LOC T (MD)
Entity Type:Individual
Prefix:
First Name:LOC
Middle Name:T
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 1:183 CITY LIMITS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608
Mailing Address - Country:US
Mailing Address - Phone:510-547-4854
Mailing Address - Fax:
Practice Address - Street 1:5555 W LAS POSITAS
Practice Address - Street 2:VALLEY CARE HOSPITAL
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94855
Practice Address - Country:US
Practice Address - Phone:925-416-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80706208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics