Provider Demographics
NPI:1407282510
Name:LE, TRIET MINH (DO)
Entity Type:Individual
Prefix:DR
First Name:TRIET
Middle Name:MINH
Last Name:LE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16543 BROOKHURST ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-2343
Mailing Address - Country:US
Mailing Address - Phone:714-837-2568
Mailing Address - Fax:
Practice Address - Street 1:16543 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2343
Practice Address - Country:US
Practice Address - Phone:714-418-9749
Practice Address - Fax:714-418-1047
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14016207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology