Individual
MARY D. LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10800 MAGNOLIA AVE, RIVERSIDE, CA 92505-3043
(951) 353-4658
Mailing address
10800 MAGNOLIA AVE, RIVERSIDE, CA 92505-3043
(951) 353-4658
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD-13845
HI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A97806
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000268870
HMSA BILLING NUMBER
HI
Enumeration date
08/31/2007
Last updated
07/21/2022
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