Provider Demographics
NPI:1083637227
Name:LE, CHRIS (MD)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HOAT
Other - Middle Name:CANH
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1433 W MERCED AVE
Mailing Address - Street 2:216
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3402
Mailing Address - Country:US
Mailing Address - Phone:626-338-3553
Mailing Address - Fax:626-338-5432
Practice Address - Street 1:1433 W MERCED AVE
Practice Address - Street 2:216
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3402
Practice Address - Country:US
Practice Address - Phone:626-338-3553
Practice Address - Fax:626-338-5432
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43125261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A431250Medicaid
CA00A431250Medicaid
CAA043125Medicare ID - Type Unspecified