Provider Demographics
NPI:1700999414
Name:LE, MINH (MD)
Entity Type:Individual
Prefix:
First Name:MINH
Middle Name:
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N 14TH ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6214
Mailing Address - Country:US
Mailing Address - Phone:408-971-1150
Mailing Address - Fax:408-971-1151
Practice Address - Street 1:25 N 14TH ST
Practice Address - Street 2:SUITE 700
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6214
Practice Address - Country:US
Practice Address - Phone:408-971-1150
Practice Address - Fax:408-971-1151
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72624207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH69026Medicare UPIN
CA00A726242Medicare PIN