Healthcare Provider Details

I. General information

NPI: 1215630611
Provider Name (Legal Business Name): DARLENE MY CHI DIEP DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N FRESNO ST
FRESNO CA
93701-2302
US

IV. Provider business mailing address

6605 NANCY RIDGE DR
SAN DIEGO CA
92121-2253
US

V. Phone/Fax

Practice location:
  • Phone: 559-499-6450
  • Fax:
Mailing address:
  • Phone: 858-750-2983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A25257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: