Healthcare Provider Details

I. General information

NPI: 1386562882
Provider Name (Legal Business Name): JEHAN GALVEZ DINIO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1067 BAYVIEW LN
HARBOR CITY CA
90710-5219
US

IV. Provider business mailing address

1067 BAYVIEW LN
HARBOR CITY CA
90710-5219
US

V. Phone/Fax

Practice location:
  • Phone: 424-387-6243
  • Fax:
Mailing address:
  • Phone: 424-387-6243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPTA50495
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: