Provider Demographics
NPI:1487218640
Name:LE, ANNIE P (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:P
Last Name:LE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 N STATE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-6574
Mailing Address - Country:US
Mailing Address - Phone:760-340-8248
Mailing Address - Fax:
Practice Address - Street 1:651 N STATE ST STE 5
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-6574
Practice Address - Country:US
Practice Address - Phone:951-292-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program