Provider Demographics
NPI:1265494223
Name:LE, THANG Q (MD)
Entity Type:Individual
Prefix:DR
First Name:THANG
Middle Name:Q
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:PO BOX 3098
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90510-3098
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:310-792-3802
Practice Address - Street 1:9201 SUNSET BLVD
Practice Address - Street 2:STE #406
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-3705
Practice Address - Country:US
Practice Address - Phone:310-887-1730
Practice Address - Fax:310-887-1734
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71456207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A714560Medicaid
CAWA71456CMedicare PIN
CAWA71456BMedicare PIN
CA00A714560Medicaid