Provider Demographics
NPI:1013284348
Name:DINH, MATTHEW HOAIVU (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:HOAIVU
Last Name:DINH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 BAGLEY AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-2937
Mailing Address - Country:US
Mailing Address - Phone:714-247-9558
Mailing Address - Fax:
Practice Address - Street 1:3535 S LA CIENEGA BLVD
Practice Address - Street 2:T-1306
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-4407
Practice Address - Country:US
Practice Address - Phone:310-895-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist