Healthcare Provider Details

I. General information

NPI: 1447502661
Provider Name (Legal Business Name): HANH HUYNH LARSON D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 CHINO AVE STE 150A
CHINO HILLS CA
91709-1295
US

IV. Provider business mailing address

3110 CHINO AVE STE 150A
CHINO HILLS CA
91709-1295
US

V. Phone/Fax

Practice location:
  • Phone: 909-630-7940
  • Fax: 909-469-2108
Mailing address:
  • Phone: 909-630-7940
  • Fax: 909-469-2108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number20A13073
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A13073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: