Individual
TIN TRUNG LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18674 SAN FELIPE ST, FOUNTAIN VALLEY, CA 92708-7121
(714) 600-7083
(714) 242-1599
Mailing address
18674 SAN FELIPE ST, FOUNTAIN VALLEY, CA 92708-7121
(714) 600-7083
(714) 242-1599
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
306005623
CA
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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