Basic Information
| Provider Information | |||||||||
| NPI: | 1891207072 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LE | ||||||||
| FirstName: | THUY VI | ||||||||
| MiddleName: | THI | ||||||||
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| Credential: | BS | ||||||||
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| OtherLastName: | LE | ||||||||
| OtherFirstName: | VI | ||||||||
| OtherMiddleName: | T. | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1541 TOLBERT DR | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951222456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4084257166 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1171 HOMESTEAD RD STE 280 | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950505486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083202590 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2017 | ||||||||
| LastUpdateDate: | 10/28/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Other |
No ID Information.