Healthcare Provider Details

I. General information

NPI: 1881344729
Provider Name (Legal Business Name): DINA ABDO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH ST FL 4
SAN FRANCISCO CA
94143-2549
US

IV. Provider business mailing address

10067 STILBITE AVE
FOUNTAIN VALLEY CA
92708-1011
US

V. Phone/Fax

Practice location:
  • Phone: 415-502-2362
  • Fax:
Mailing address:
  • Phone: 714-519-4562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA191549
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: