Individual provider Active NPI

Anh-Dao Vu Le, MD

  • Dermatology Physician
  • Tustin, CA
National Provider Identifier
1619946779
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A81117 Issued in CA
Practice address
13420 Newport Ave Ste G
Tustin, CA 92780-3745
Phone
(714) 659-6504
Fax
(714) 908-7596
NPI assigned
Mar 14, 2006
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A81117 CA Primary

Addresses

Primary practice location

13420 Newport Ave Ste G
Tustin, CA 92780-3745

Mailing address

2190 Saltbush Cir
Corona, CA 92882-2321
Phone (714) 797-2033

Other practice location 1

495 Old Newport Blvd Ste 200
Newport Beach, CA 92663-4204
Phone (949) 646-7546

Other practice location 2

1024 E Pacific Coast Hwy
Long Beach, CA 90806-5017
Phone (909) 581-6732

Other identifiers 1

IdentifierTypeStateIssuer
00A81117MedicaidCA

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
I20050706000726 CA Practitioner - Dermatology 1759327224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Miami, LM Miller School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ocean Skin and Vein InstituteGroup PAC ID 9335482835, 16 clinicians
Hung V. Ong, MD., Inc.Group PAC ID 6406823830, 3 clinicians

Practice addresses (Care Compare)

13420 Newport Ave
Suite G
Tustin, CA 92780-3745
Phone (714) 731-0061

495 Old Newport Blvd
Suite 200
Newport Beach, CA 92663-4204
Phone (949) 646-7546

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision41
Removal of tissue1-10
Removal of skin lesions1086
Removal of skin cancer102
Removal or shaving of skin growth54
Skin biopsy384

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81117CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Skin and Vein Institute Dermatology CurrentSince Jul 28, 2020 Accepting new patients
Hung V. Ong, MD., Inc. Dermatology CurrentSince May 1, 2017 Accepting new patients
Medsense Medical, Inc. PastSince Mar 19, 2018 Accepting new patients

Locations

1101 N Sepulveda Blvd
Ste 100
Manhattan Beach, CA 90266
Phone (310) 370-5670

495 Old Newport Blvd
Ste 200
Newport Beach, CA 92663
Phone (949) 646-7546

3661 Torrance Blvd
Ste 104
Torrance, CA 90503
Phone (310) 370-5670

13420 Newport Ave
Ste G
Tustin, CA 92780
Phone (714) 731-0061

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1619946779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 SALTBUSH CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822321",
            "telephone_number": "714-797-2033",
            "fax_number": "714-908-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13420 NEWPORT AVE STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803745",
            "telephone_number": "714-659-6504",
            "fax_number": "714-908-7596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 Old Newport Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926634204",
            "country_code": "US",
            "telephone_number": "949-646-7546",
            "fax_number": "949-646-7556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1024 E Pacific Coast Hwy",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908065017",
            "country_code": "US",
            "telephone_number": "909-581-6732",
            "fax_number": "909-581-6737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "ANH-DAO",
        "middle_name": "VU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-07-14",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A81117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A81117",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.