Le, Mimi Quyen Thai Thuc

Le, Mimi Quyen Thai Thuc is an individual health care provider with primary practice located at 10800 Magnolia Ave , Riverside CA 92505-3043. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Le, Mimi Quyen Thai Thuc can be contacted via phone (866) 984-7483.

Contact Information

Primary practice address
10800 Magnolia Ave Riverside CA 92505-3043
Fax: (951) 353-5073
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X A88869 California
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X A88869 California

Profile Details

NPI number 1124070420
LBN Legal business name Le, Mimi Quyen Thai Thuc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Dec 13th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124070420 NPPES
California MEDICAID 00A888690

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