Healthcare Provider Details

I. General information

NPI: 1093123176
Provider Name (Legal Business Name): DINH LAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1749 N GARVEY AVE
POMONA CA
91767
US

IV. Provider business mailing address

510 N 13TH AVE STE 101
UPLAND CA
91786-4973
US

V. Phone/Fax

Practice location:
  • Phone: 909-729-5079
  • Fax:
Mailing address:
  • Phone: 909-985-8838
  • Fax: 909-985-8899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95026951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: