Provider Demographics
NPI:1558391052
Name:DINH, VICTOR HIEU (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:HIEU
Last Name:DINH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16603 CAMILIA AVE
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1909
Mailing Address - Country:US
Mailing Address - Phone:949-378-8179
Mailing Address - Fax:714-530-0777
Practice Address - Street 1:9746 WESTMINSTER AVE
Practice Address - Street 2:SUITE D2
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2984
Practice Address - Country:US
Practice Address - Phone:714-530-0776
Practice Address - Fax:714-530-0777
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50555207Q00000X
LA021228207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C505550Medicaid
CAC50555Medicare ID - Type UnspecifiedMEDICARE BILLING NUMBER
CA00C505550Medicaid