Provider Demographics
NPI:1881657468
Name:LE, HA THI NGOC (MD)
Entity Type:Individual
Prefix:
First Name:HA
Middle Name:THI NGOC
Last Name:LE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11525 MAMMOTH PEAK CT
Mailing Address - Street 2:
Mailing Address - City:ALTA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-6571
Mailing Address - Country:US
Mailing Address - Phone:909-881-7320
Mailing Address - Fax:909-881-7320
Practice Address - Street 1:4990 ARLINGTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-2757
Practice Address - Country:US
Practice Address - Phone:909-881-7320
Practice Address - Fax:909-881-7330
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA51417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A514170Medicare ID - Type Unspecified