Provider Demographics
NPI:1457317091
Name:HINH, ANH KIM (OD)
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:KIM
Last Name:HINH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4851 YALE ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2242
Mailing Address - Country:US
Mailing Address - Phone:714-467-6118
Mailing Address - Fax:
Practice Address - Street 1:5513 PHILADELPHIA ST
Practice Address - Street 2:SUITE A
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-7534
Practice Address - Country:US
Practice Address - Phone:909-628-1226
Practice Address - Fax:909-628-5483
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11889T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist