Provider Demographics
NPI:1891106464
Name:DINH, HAN NGOC (DO)
Entity Type:Individual
Prefix:
First Name:HAN
Middle Name:NGOC
Last Name:DINH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HAN
Other - Middle Name:NGOC
Other - Last Name:LUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5330 SAN BERNARDINO ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2952
Mailing Address - Country:US
Mailing Address - Phone:866-205-3595
Mailing Address - Fax:
Practice Address - Street 1:9961 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:909-427-5603
Practice Address - Fax:909-427-5312
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A146632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program