Provider Demographics
NPI:1356545925
Name:LE, THONG DINH (MD)
Entity type:Individual
Prefix:DR
First Name:THONG
Middle Name:DINH
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9940 KAPALUA LN
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5035
Mailing Address - Country:US
Mailing Address - Phone:209-479-1641
Mailing Address - Fax:
Practice Address - Street 1:5925 BAR HARBOUR CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-4230
Practice Address - Country:US
Practice Address - Phone:916-684-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111231207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3849179378OtherMYUTMB 3849179378-COMMERCIAL NUMBER