Healthcare Provider Details

I. General information

NPI: 1083255871
Provider Name (Legal Business Name): LINA HUYNH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14501 MAGNOLIA ST STE 108
WESTMINSTER CA
92683-1307
US

IV. Provider business mailing address

15811 EXETER ST
WESTMINSTER CA
92683-7514
US

V. Phone/Fax

Practice location:
  • Phone: 714-799-7731
  • Fax:
Mailing address:
  • Phone: 714-705-5598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95012289
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNP95012289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: