Provider Demographics
NPI:1124318522
Name:LE LEANNEC, ISABELLE CHUMFONG (MD)
Entity type:Individual
Prefix:DR
First Name:ISABELLE
Middle Name:CHUMFONG
Last Name:LE LEANNEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ISABELLE
Other - Middle Name:TCHOUGEN
Other - Last Name:CHUMFONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:80 BROADWAY ST NE UNIT 305
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-8102
Mailing Address - Country:US
Mailing Address - Phone:925-640-8752
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE ST SE
Practice Address - Street 2:PWB 11-1145, MMC 195
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:715-222-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN66148208600000X
CAA123313208600000X
NY306233208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery