Individual provider Active NPI

Mary Thuy Le, DPT

  • Pediatric Physical Therapist
  • Garden Grove, CA
National Provider Identifier
1518231224
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
38672 Issued in CA
Practice address
12881 Knott St Ste 103
Garden Grove, CA 92841-3939
Phone
(714) 892-6828
Fax
(714) 898-9720
NPI assigned
Feb 27, 2012
Last updated
Feb 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 38672 CA Primary

Addresses

Primary practice location

12881 Knott St Ste 103
Garden Grove, CA 92841-3939

Mailing address

12881 Knott St Ste 103
Garden Grove, CA 92841-3939
Phone (714) 892-6828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38672CAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1518231224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12881 KNOTT ST STE 103",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928413939",
            "telephone_number": "714-892-6828",
            "fax_number": "714-898-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12881 KNOTT ST STE 103",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928413939",
            "telephone_number": "714-892-6828",
            "fax_number": "714-898-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "MARY",
        "middle_name": "THUY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "38672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.