Provider Demographics
NPI:1225363625
Name:LE HOANG MED INC
Entity Type:Organization
Organization Name:LE HOANG MED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHI
Authorized Official - Middle Name:TD
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-962-0030
Mailing Address - Street 1:933 S SUNSET AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3410
Mailing Address - Country:US
Mailing Address - Phone:626-962-0030
Mailing Address - Fax:626-962-0648
Practice Address - Street 1:933 S SUNSET AVE STE 201
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3410
Practice Address - Country:US
Practice Address - Phone:626-962-0030
Practice Address - Fax:626-962-0648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA692590261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center