Individual provider Active NPI

Tuan Dai Le, MD

  • Family Medicine Physician
  • Pomona, CA
National Provider Identifier
1528243359
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A60032 Issued in CA
Practice address
1151 E Holt Ave
Suite Q
Pomona, CA 91767-5813
Phone
(909) 620-8436
Fax
(909) 868-5134
NPI assigned
Dec 28, 2007
Last updated
Jun 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A60032 CA Primary

Addresses

Primary practice location

1151 E Holt Ave
Suite Q
Pomona, CA 91767-5813

Mailing address

1151 E Holt Ave
Suite Q
Pomona, CA 91767-5813
Phone (909) 620-8436

Other identifiers 1

IdentifierTypeStateIssuer
00A600321MedicaidCA

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
I20060419000831 CA Practitioner - General PracticePractitioner - Family Practice 8022027028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Milwaukee Medical College, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1151 E Holt Ave
Suite Q
Pomona, CA 91767-5828
Phone (909) 620-8436

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A60032CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuan Dai Le, M.D, a Professional Corporation Family Medicine CurrentSince Nov 1, 2001 Accepting new patients
THC - Orange County, LLC Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Harry E Confer DPM a Professional Corp Past Accepting new patients
Prime Healthcare Services - Montclair, LLC Past Accepting new patients

Locations

5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111

1151 E Holt Ave
Ste Q
Pomona, CA 91767
Phone (909) 620-8436

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 1

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": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1528243359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E HOLT AVE",
            "address_2": "SUITE Q",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675813",
            "telephone_number": "909-620-8436",
            "fax_number": "909-868-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E HOLT AVE",
            "address_2": "SUITE Q",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675813",
            "telephone_number": "909-620-8436",
            "fax_number": "909-868-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "TUAN",
        "middle_name": "DAI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A60032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A600321",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.