Individual
MARY LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
751 SOUTH BASCOM AVENUE, NICU, SAN JOSE, CA 95128-2604
(415) 933-4082
Mailing address
751 SOUTH BASCOM AVENUE, NICU, SAN JOSE, CA 95128-2604
(415) 933-4082
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95005484
CA
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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