Provider Demographics
NPI:1619237468
Name:LE, HUY QUANG (MD)
Entity Type:Individual
Prefix:
First Name:HUY
Middle Name:QUANG
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14571 MAGNOLIA ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5575
Mailing Address - Country:US
Mailing Address - Phone:714-893-1915
Mailing Address - Fax:714-492-8501
Practice Address - Street 1:14571 MAGNOLIA ST STE 101
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5575
Practice Address - Country:US
Practice Address - Phone:714-893-1915
Practice Address - Fax:714-492-8501
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1274692085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program