Provider Demographics
NPI:1649555293
Name:MANGUNE, HELEN HUONG LE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HELEN HUONG
Middle Name:LE
Last Name:MANGUNE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:HUONG HELEN
Other - Middle Name:THANH
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5606 LAKEWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712
Mailing Address - Country:US
Mailing Address - Phone:818-300-5394
Mailing Address - Fax:
Practice Address - Street 1:16660 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5433
Practice Address - Country:US
Practice Address - Phone:562-480-7288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant