Provider Demographics
NPI:1063475614
Name:HUYNH, LINH CHI (DPM)
Entity Type:Individual
Prefix:DR
First Name:LINH
Middle Name:CHI
Last Name:HUYNH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 E CANAL DR STE 10
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4542
Mailing Address - Country:US
Mailing Address - Phone:209-667-5255
Mailing Address - Fax:209-667-5257
Practice Address - Street 1:875 E CANAL DR STE 10
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4542
Practice Address - Country:US
Practice Address - Phone:209-667-5255
Practice Address - Fax:209-667-5257
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4305213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E43050Medicaid
CA000E43052Medicaid
CA000E43051Medicaid
CA000E43052Medicaid
CA000E43052Medicare PIN
CA5098450002Medicare NSC
CA000E43051Medicaid
CA5098450001Medicare NSC