Provider Demographics
NPI:1033511142
Name:LUONG, TINH (MD, PHD)
Entity Type:Individual
Prefix:
First Name:TINH
Middle Name:
Last Name:LUONG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:TINH
Other - Middle Name:
Other - Last Name:LEUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:14659 OLIVE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1652
Mailing Address - Country:US
Mailing Address - Phone:818-485-0888
Mailing Address - Fax:
Practice Address - Street 1:14659 OLIVE VIEW DR
Practice Address - Street 2:OLIVE VIEW COMMUNITY URGENT CARE CENTER
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1652
Practice Address - Country:US
Practice Address - Phone:818-485-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1299792084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program