Provider Demographics
NPI:1598809261
Name:DINH, NHAN THANH (DC)
Entity Type:Individual
Prefix:DR
First Name:NHAN
Middle Name:THANH
Last Name:DINH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4152 WATKINS WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-1047
Mailing Address - Country:US
Mailing Address - Phone:408-930-9103
Mailing Address - Fax:
Practice Address - Street 1:1669 FLANIGAN DR
Practice Address - Street 2:SUITE F
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1682
Practice Address - Country:US
Practice Address - Phone:408-883-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-28058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU95075Medicare UPIN