Provider Demographics
NPI:1184705600
Name:LE, HONG-CHAU THI (OD)
Entity type:Individual
Prefix:DR
First Name:HONG-CHAU
Middle Name:THI
Last Name:LE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5337 HAMNER AVE UNIT 709
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:91752-1042
Mailing Address - Country:US
Mailing Address - Phone:951-456-0088
Mailing Address - Fax:844-273-2243
Practice Address - Street 1:5337 HAMNER AVE UNIT 709
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:91752-1042
Practice Address - Country:US
Practice Address - Phone:951-456-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12428T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACC257YMedicare PIN