Provider Demographics
NPI:1053463232
Name:DINH, MICHAEL Q (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:Q
Last Name:DINH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:225 S LAKE AVE
Mailing Address - Street 2:SUITE 535
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3005
Mailing Address - Country:US
Mailing Address - Phone:626-795-6596
Mailing Address - Fax:626-795-8247
Practice Address - Street 1:435 H ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4307
Practice Address - Country:US
Practice Address - Phone:619-691-7000
Practice Address - Fax:619-691-7443
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG80594207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G805940Medicaid
CA00G805940Medicaid
G58714Medicare UPIN
CAG80594AMedicare PIN