Healthcare Provider Details

I. General information

NPI: 1306257381
Provider Name (Legal Business Name): HUYENLAN DINH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1377 S GRAND AVE
GLENDORA CA
91740-5047
US

IV. Provider business mailing address

1377 S GRAND AVE
GLENDORA CA
91740-5047
US

V. Phone/Fax

Practice location:
  • Phone: 626-857-2500
  • Fax: 626-857-2572
Mailing address:
  • Phone: 626-857-2500
  • Fax: 626-857-2572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number20A15249
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number20A15249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: