Individual provider Active NPI

Michelle Dang Le

  • Medical Physician Assistant
  • Corona, CA
National Provider Identifier
1871227751
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
970 Homestead Rd
Corona, CA 92878-9757
Phone
(714) 823-0550
NPI assigned
Jul 14, 2022
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
Medical Physician Assistant 363AM0700X CA Primary

Addresses

Primary practice location

970 Homestead Rd
Corona, CA 92878-9757

Mailing address

970 Homestead Rd
Corona, CA 92878-9757
Phone (714) 823-0550

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812001255 CA Practitioner - Physician Assistant 4385182161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Los Angeles Free ClinicGroup PAC ID 5395886311, 26 clinicians

Practice addresses (Care Compare)

5205 Melrose Ave
Los Angeles, CA 90038-3144
Phone (323) 653-1990

6043 Hollywood Blvd
Los Angeles, CA 90028-5411
Phone (323) 653-1990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Los Angeles Free Clinic Current Accepting new patients

Locations

8405 Beverly Blvd
West Hollywood, CA 90048
Phone (323) 653-1990

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1871227751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 HOMESTEAD RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928789757",
            "telephone_number": "714-823-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 HOMESTEAD RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928789757",
            "telephone_number": "714-823-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "MICHELLE",
        "middle_name": "DANG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.