Provider Demographics
NPI:1497041164
Name:GIANG, ERIC LE (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:LE
Last Name:GIANG
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 1:2116 E ORANGEBURG AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3370
Mailing Address - Country:US
Mailing Address - Phone:209-577-1411
Mailing Address - Fax:
Practice Address - Street 1:2116 E ORANGEBURG AVE STE A
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3370
Practice Address - Country:US
Practice Address - Phone:209-577-1411
Practice Address - Fax:209-577-1239
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7880207X00000X
390200000X
CA20A15447207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program