Healthcare Provider Details

I. General information

NPI: 1093863961
Provider Name (Legal Business Name): LONG THAI DINH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3733 SAN DIMAS ST
BAKERSFIELD CA
93301-1407
US

IV. Provider business mailing address

3733 SAN DIMAS ST
BAKERSFIELD CA
93301-1407
US

V. Phone/Fax

Practice location:
  • Phone: 800-353-5400
  • Fax:
Mailing address:
  • Phone: 800-353-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA80158
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA80158
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: