| Dr Richard T Le, DO | |
|
12611 Hesperia Rd Ste A, Victorville, CA 92395-8307 | |
| (760) 951-7762 | |
| (760) 951-7134 |
| Full Name | Dr Richard T Le |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 12611 Hesperia Rd Ste A, Victorville, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417070566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A12033 (California) | Secondary |
| 207Q00000X | Family Medicine | N4544 (Texas) | Secondary |
| 207N00000X | Dermatology | 20A12033 (California) | Primary |
| Entity Name | Island Dermatology, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508815556 PECOS PAC ID: 1850395070 Enrollment ID: O20060830000569 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Richard T Le, DO 12611 Hesperia Rd, Ste A, Victorville, CA 92395-8307 Ph: (760) 951-7762 | Dr Richard T Le, DO 12611 Hesperia Rd Ste A, Victorville, CA 92395-8307 Ph: (760) 951-7762 |
Hai T Tran, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 12611 Hesperia Rd, Suite A, Victorville, CA 92395 Phone: 760-951-8714 Fax: 760-951-7134 | |
Liza Gill, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 12565 Hesperia Rd Ste 3, Victorville, CA 92395 Phone: 760-780-0003 Fax: 760-766-1908 | |
Keith Mark Gross, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 12550 Hesperia Rd, 400, Victorville, CA 92395 Phone: 909-335-8638 Fax: 909-335-8644 |