Provider Demographics
NPI:1851396790
Name:LE, HIEU H (MD)
Entity Type:Individual
Prefix:DR
First Name:HIEU
Middle Name:H
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HIEU
Other - Middle Name:HUE
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:58 MONSERRAT PL
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-1903
Mailing Address - Country:US
Mailing Address - Phone:949-837-7116
Mailing Address - Fax:
Practice Address - Street 1:58 MONSERRAT PL
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-1903
Practice Address - Country:US
Practice Address - Phone:949-837-7116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5400207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161183201Medicaid
TX098673905Medicaid
TX0012KHOtherBCBS IND. PROV. #
TX770603443OtherTAX ID #
TX8B1483Medicare ID - Type UnspecifiedIND. PROV. #
TX00749VMedicare ID - Type UnspecifiedGROUP #
TX098673905Medicaid