Provider Demographics
NPI:1568501005
Name:LE, CHUONG MINH (MD)
Entity type:Individual
Prefix:DR
First Name:CHUONG
Middle Name:MINH
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:336 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1844
Mailing Address - Country:US
Mailing Address - Phone:615-346-8182
Mailing Address - Fax:615-829-8950
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:SUITE 475
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1500
Practice Address - Country:US
Practice Address - Phone:615-346-8182
Practice Address - Fax:615-829-8950
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD727102084N0008X
KY435042084N0008X
TNMD00000468152084N0008X
TXN82082084N0008X
WAMD602136932084N0008X
NV140152084N0008X
MI43010994092084N0008X
NY2624092084N0008X
SCTL340682084N0008X
VA102504742084N0008X
NJ25MAA089847002084N0008X
CT505092084N0400X
NMTM2013-00242084N0400X
KYIP9702084N0400X
CAA1125262084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFH493ZOtherMEDICARE PTAN- INDIVIDUAL
TN103I136760OtherMEDICARE PTAN- INDIVIDUAL