Provider Demographics
NPI:1235135633
Name:LE, CHAU MINH (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAU
Middle Name:MINH
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 1:9206 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1900
Mailing Address - Country:US
Mailing Address - Phone:626-571-2763
Mailing Address - Fax:626-571-7330
Practice Address - Street 1:9206 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1900
Practice Address - Country:US
Practice Address - Phone:626-571-2763
Practice Address - Fax:626-571-7330
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48923207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A489231Medicaid
CA00A489231Medicaid
CAA48923Medicare ID - Type Unspecified