Healthcare Provider Details

I. General information

NPI: 1790562981
Provider Name (Legal Business Name): MISS BAO HAN NGOC DINH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS HANNAH DINH

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 06/17/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 E DEERE AVE STE 240
SANTA ANA CA
92705-5716
US

IV. Provider business mailing address

1932 E DEERE AVE STE 240
SANTA ANA CA
92705-5716
US

V. Phone/Fax

Practice location:
  • Phone: 714-543-4333
  • Fax: 714-543-4398
Mailing address:
  • Phone: 714-543-4333
  • Fax: 714-543-4398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberNA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: