Provider Demographics
NPI:1275570491
Name:TRINH, HA THANH (DPT)
Entity Type:Individual
Prefix:MR
First Name:HA
Middle Name:THANH
Last Name:TRINH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 EL CAMINO REAL
Mailing Address - Street 2:UNIT 208
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-1203
Mailing Address - Country:US
Mailing Address - Phone:323-229-1269
Mailing Address - Fax:
Practice Address - Street 1:1488 EL CAMINO REAL
Practice Address - Street 2:UNIT 208
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-1203
Practice Address - Country:US
Practice Address - Phone:323-229-1269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32469174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist