Healthcare Provider Details

I. General information

NPI: 1558280479
Provider Name (Legal Business Name): RYAN DINH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 E 120TH ST
LOS ANGELES CA
90059-3051
US

IV. Provider business mailing address

19032 HAMDEN LN
HUNTINGTON BEACH CA
92646-2134
US

V. Phone/Fax

Practice location:
  • Phone: 323-568-3347
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberP000044300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: