Provider Demographics
NPI:1144598897
Name:CAM VAN LE,MD,INC
Entity Type:Organization
Organization Name:CAM VAN LE,MD,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAM
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-894-9666
Mailing Address - Street 1:9341 BOLSA AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5928
Mailing Address - Country:US
Mailing Address - Phone:714-894-9666
Mailing Address - Fax:714-894-6387
Practice Address - Street 1:9341 BOLSA AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5928
Practice Address - Country:US
Practice Address - Phone:714-894-9666
Practice Address - Fax:714-894-6387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42446208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty