Provider Demographics
NPI:1790017952
Name:LE, LUAN (MD, CMCM)
Entity Type:Individual
Prefix:DR
First Name:LUAN
Middle Name:
Last Name:LE
Suffix:
Gender:M
Credentials:MD, CMCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26318 NORMA JEAN PL
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26318 NORMA JEAN PL
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-4900
Practice Address - Country:US
Practice Address - Phone:951-230-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No174H00000XOther Service ProvidersHealth Educator