Individual
LONG LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14445 OLIVE VIEW DR, DEPARTMENT OF MEDICINE 2B, 182, SYLMAR, CA 91342-1437
(818) 364-1555
Mailing address
14371 WILDEVE LN, TUSTIN, CA 92780-5723
(408) 646-1097
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A152605
CA
207RG0100X
Gastroenterology Physician
Primary
A152605
CA
Other
Enumeration date
05/05/2016
Last updated
09/24/2024
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