Provider Demographics
NPI:1265540512
Name:LE, PRESTON P (DC)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:P
Last Name:LE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9361 BOLSA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5953
Mailing Address - Country:US
Mailing Address - Phone:714-863-8808
Mailing Address - Fax:714-775-7590
Practice Address - Street 1:9361 BOLSA AVE STE 104
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5953
Practice Address - Country:US
Practice Address - Phone:714-863-8808
Practice Address - Fax:714-775-7590
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD.C.27797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD.C.27797Medicare ID - Type Unspecified