Provider Demographics
NPI:1669401477
Name:DINH-CHUNG, HELEN T (PA-C)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:T
Last Name:DINH-CHUNG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:5406 SUNRISE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7805
Practice Address - Country:US
Practice Address - Phone:800-972-5547
Practice Address - Fax:916-887-7963
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16265207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPA162650OtherMEDI CAL
CAP01288576/DS9933OtherRAILROAD MEDICARE-55TH ST.
CAP01485480-DV5277OtherRR MEDICARE
CAOPA162650Medicaid
CAAW282ZMedicare PIN
CAP01485480-DV5277OtherRR MEDICARE
CAOPA162650OtherMEDI CAL
P60778Medicare UPIN
CACA142287Medicare UPIN