Provider Demographics
NPI:1235158965
Name:LE, HANH MY (MD)
Entity Type:Individual
Prefix:
First Name:HANH
Middle Name:MY
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 1:11939 RANCHO BERNARDO RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2073
Mailing Address - Country:US
Mailing Address - Phone:858-613-8949
Mailing Address - Fax:858-613-8953
Practice Address - Street 1:11939 RANCHO BERNARDO RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2073
Practice Address - Country:US
Practice Address - Phone:858-613-8949
Practice Address - Fax:858-613-8953
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87539207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G875390OtherBLUE SHIELD
CA00G875390OtherBLUE SHIELD
CAWA87539AMedicare ID - Type Unspecified