Individual
BAOAN GIA LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4527 N 27TH AVE, PHOENIX, AZ 85017-3702
(602) 249-4508
(602) 249-1614
Mailing address
2325 E SHEA BLVD, PHOENIX, AZ 85028-3115
(918) 344-0130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23089
OK
207Q00000X
Family Medicine Physician
Primary
36389
AZ
207Q00000X
Family Medicine Physician
ME 94404
FL
Other
Enumeration date
10/17/2006
Last updated
04/15/2008
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