Provider Demographics
NPI:1639244049
Name:DINH, CHINH THIEN (MD)
Entity type:Individual
Prefix:
First Name:CHINH
Middle Name:THIEN
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 1:3414 W BALL RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3726
Mailing Address - Country:US
Mailing Address - Phone:714-761-9137
Mailing Address - Fax:714-761-7034
Practice Address - Street 1:3414 W BALL RD
Practice Address - Street 2:SUITE F
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3726
Practice Address - Country:US
Practice Address - Phone:714-761-9137
Practice Address - Fax:714-761-7034
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A654280Medicaid
CA00A654280Medicaid