Provider Demographics
NPI:1497877948
Name:DINH, MICHAEL QUOC (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:QUOC
Last Name:DINH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:190 GOLF COURSE DR
Mailing Address - Street 2:APT. #358
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-4917
Mailing Address - Country:US
Mailing Address - Phone:707-588-8656
Mailing Address - Fax:
Practice Address - Street 1:5901 REDWOOD DR
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2076
Practice Address - Country:US
Practice Address - Phone:707-588-8656
Practice Address - Fax:707-540-9137
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11874TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist