Basic Information
| Provider Information | |||||||||
| NPI: | 1316002116 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LE | ||||||||
| FirstName: | QUYNH-THU | ||||||||
| MiddleName: | XUAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 875 BLAKE WILBUR DR | ||||||||
| Address2: | MC 5847 | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943042205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504985032 | ||||||||
| FaxNumber: | 6507258231 | ||||||||
| Practice Location | |||||||||
| Address1: | 875 BLAKE WILBUR DR | ||||||||
| Address2: | MC 5847 | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943042205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504985032 | ||||||||
| FaxNumber: | 6507258231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2006 | ||||||||
| LastUpdateDate: | 09/20/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0203X | G079675 | CA | Y | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology |
No ID Information.