Provider Demographics
NPI:1154345536
Name:LE, JOE P (MD)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:P
Last Name:LE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8120 TIMBERLAKE WAY
Mailing Address - Street 2:STE. 207
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5412
Mailing Address - Country:US
Mailing Address - Phone:916-691-5855
Mailing Address - Fax:916-691-6606
Practice Address - Street 1:8120 TIMBERLAKE WAY
Practice Address - Street 2:STE. 207
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5412
Practice Address - Country:US
Practice Address - Phone:916-691-5855
Practice Address - Fax:916-691-6606
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA76940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH85564Medicare UPIN