Provider Demographics
NPI:1952331449
Name:LE, DUYEN B (OD)
Entity Type:Individual
Prefix:MS
First Name:DUYEN
Middle Name:B
Last Name:LE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SUSIE DUYEN
Other - Middle Name:B
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10660 SOUTHERN HIGHLANDS PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4113
Mailing Address - Country:US
Mailing Address - Phone:714-767-5785
Mailing Address - Fax:
Practice Address - Street 1:3869 STOCKDALE HIGHWAY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-831-8952
Practice Address - Fax:661-831-5042
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12403T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U96998Medicare UPIN