Provider Demographics
NPI:1598304446
Name:JENNY HUONG LE, O.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:JENNY HUONG LE, O.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:HUONG
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:661-942-3849
Mailing Address - Street 1:44407 10TH ST W STE B
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3345
Mailing Address - Country:US
Mailing Address - Phone:661-942-3849
Mailing Address - Fax:
Practice Address - Street 1:44407 10TH ST W STE B
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3345
Practice Address - Country:US
Practice Address - Phone:661-942-3849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty