Provider Demographics
NPI:1295756369
Name:LE, MINH-HOANG NGUYEN (MD)
Entity type:Individual
Prefix:
First Name:MINH-HOANG
Middle Name:NGUYEN
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 W ASPERA BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7947
Mailing Address - Country:US
Mailing Address - Phone:623-465-6060
Mailing Address - Fax:623-242-5833
Practice Address - Street 1:7701 W ASPERA BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7947
Practice Address - Country:US
Practice Address - Phone:623-465-6060
Practice Address - Fax:623-242-5833
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29099207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH36224Medicare UPIN
AZZ145367Medicare PIN
AZ109015Medicare PIN
AZ109016Medicare PIN