Provider Demographics
NPI:1164104535
Name:DINH, SOPHIA (PA-C)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:DINH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:858 TEMPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1265
Mailing Address - Country:US
Mailing Address - Phone:408-666-3398
Mailing Address - Fax:
Practice Address - Street 1:1580 VALENCIA ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4420
Practice Address - Country:US
Practice Address - Phone:415-550-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA62693207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine