Provider Demographics
NPI:1396478400
Name:LE, TAYLOR THIEN MINH (PA-C)
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:THIEN MINH
Last Name:LE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1000 SOUTH FREMONT AVENUE
Mailing Address - Street 2:UNIT 7 BUILDING A10 STE N10100
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:855 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3819
Practice Address - Country:US
Practice Address - Phone:833-867-4642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2023-06-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty