Provider Demographics
NPI:1760102933
Name:LE, DANIEL BUU NGOC (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL BUU
Middle Name:NGOC
Last Name:LE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 W KENT AVE UNIT 7
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-2389
Mailing Address - Country:US
Mailing Address - Phone:714-657-4755
Mailing Address - Fax:
Practice Address - Street 1:12460 EUCLID ST STE 102
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-3351
Practice Address - Country:US
Practice Address - Phone:714-638-4852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36414111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor