Healthcare Provider Details

I. General information

NPI: 1841154077
Provider Name (Legal Business Name): CHANDLER HOANG-PHI DINH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11175 CAMPUS ST
LOMA LINDA CA
92350-1700
US

IV. Provider business mailing address

11588 LAWTON CT
LOMA LINDA CA
92354-3326
US

V. Phone/Fax

Practice location:
  • Phone: 407-388-8572
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: