Provider Demographics
NPI:1710089081
Name:DINH, JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
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 1:39765 DATE ST.
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9101
Mailing Address - Country:US
Mailing Address - Phone:951-894-4665
Mailing Address - Fax:951-894-4667
Practice Address - Street 1:39765 DATE ST.
Practice Address - Street 2:SUITE 102
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9101
Practice Address - Country:US
Practice Address - Phone:951-894-4665
Practice Address - Fax:951-894-4667
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA71987207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH51483Medicare UPIN