Provider Demographics
NPI:1831355916
Name:KIM-THANH THI DINH, INC.
Entity type:Organization
Organization Name:KIM-THANH THI DINH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM THANH
Authorized Official - Middle Name:THI
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-528-0991
Mailing Address - Street 1:1652 E CAPITOL EXPY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1839
Mailing Address - Country:US
Mailing Address - Phone:408-528-0991
Mailing Address - Fax:408-528-0994
Practice Address - Street 1:1652 E CAPITOL EXPY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1839
Practice Address - Country:US
Practice Address - Phone:408-528-0991
Practice Address - Fax:408-528-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACOR1042152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962496588Medicare PIN
CAZZZ24365ZMedicare UPIN