Individual provider Active NPI

Pha C Le, D.O.

  • Emergency Medicine Physician
  • Redlands, CA
National Provider Identifier
1184631954
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A9993 Issued in CA
Practice address
1260 Magnolia Ave
Redlands, CA 92373-4902
Phone
(714) 566-5235
NPI assigned
Aug 2, 2006
Last updated
Aug 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036115367 IL
Emergency Medicine Physician 207P00000X 20A9993 CA Primary

Addresses

Primary practice location

1260 Magnolia Ave
Redlands, CA 92373-4902

Mailing address

1260 Magnolia Ave
Redlands, CA 92373-4902
Phone (714) 566-5235

Other identifiers 1

IdentifierTypeStateIssuer
20A 9990OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080625000774 CA Practitioner - Emergency Medicine 1052317104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians

Practice addresses (Care Compare)

12601 Garden Grove Blvd
Garden Grove, CA 92843-1908
Phone (714) 537-5160

27300 Iris Ave
Moreno Valley, CA 92555-4802
Phone (651) 243-0811

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
9993CAMDAddiction (Substance Use Disorder) Counselor
036115367ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Oct 1, 2008 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Oct 1, 2008 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

751 Medical Center Ct
#1182
Chula Vista, CA 91911

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

3300 Renner Dr
Fortuna, CA 95540
Phone (707) 725-3361

9920 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 236-4000

12601 Garden Grove Blvd
Garden Grove, CA 92843
Phone (714) 537-5160

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

27300 Iris Ave
Moreno Valley, CA 92555
Phone (909) 243-0811

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

Interoperability endpoints

  • Direct secure messaging: ple730177@direct.memorialcare.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1184631954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 MAGNOLIA AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734902",
            "telephone_number": "714-566-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 MAGNOLIA AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734902",
            "telephone_number": "714-566-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "PHA",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036115367",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A9993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20A 9990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.