Provider Demographics
NPI:1790129989
Name:LE, STEPHANIE Y (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:Y
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1490 MASON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-4222
Mailing Address - Country:US
Mailing Address - Phone:415-364-7600
Mailing Address - Fax:415-986-1130
Practice Address - Street 1:1490 MASON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4222
Practice Address - Country:US
Practice Address - Phone:415-364-7600
Practice Address - Fax:415-986-1130
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA136253207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine