Provider Demographics
NPI:1841751088
Name:LE, THUYVY (DO)
Entity type:Individual
Prefix:
First Name:THUYVY
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 LEXANN AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1794
Mailing Address - Country:US
Mailing Address - Phone:408-440-4681
Mailing Address - Fax:408-564-6831
Practice Address - Street 1:1569 LEXANN AVE STE 114
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1794
Practice Address - Country:US
Practice Address - Phone:408-440-4681
Practice Address - Fax:408-564-6831
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAOS19365207R00000X
CAA19365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program