Provider Demographics
NPI:1417384801
Name:LE, SANDY (ND)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11724 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2600
Mailing Address - Country:US
Mailing Address - Phone:818-331-4386
Mailing Address - Fax:818-331-4386
Practice Address - Street 1:11724 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2600
Practice Address - Country:US
Practice Address - Phone:818-331-4386
Practice Address - Fax:818-331-4386
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANDF750175F00000X
OR1965175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath