Provider Demographics
NPI:1780881490
Name:DIAL, LINO A (MD)
Entity type:Individual
Prefix:DR
First Name:LINO
Middle Name:A
Last Name:DIAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:714-950 SAGEBRUSH BLVD
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-6722
Mailing Address - Country:US
Mailing Address - Phone:530-254-6764
Mailing Address - Fax:530-254-6776
Practice Address - Street 1:500 1ST AVE
Practice Address - Street 2:
Practice Address - City:PORTOLA
Practice Address - State:CA
Practice Address - Zip Code:96122-9406
Practice Address - Country:US
Practice Address - Phone:530-832-6500
Practice Address - Fax:530-832-4494
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA-21932207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine