Provider Demographics
NPI:1851692511
Name:LE, PHUONG KIM (NP)
Entity Type:Individual
Prefix:MRS
First Name:PHUONG
Middle Name:KIM
Last Name:LE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:16790 CABERNET CIR
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-7081
Mailing Address - Country:US
Mailing Address - Phone:408-779-5382
Mailing Address - Fax:408-779-5382
Practice Address - Street 1:710 LAWRENCE EXPY
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-0539
Practice Address - Fax:408-851-0521
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2022-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAF0910419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily