=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356978639
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL THANH DINH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2020
-----------------------------------------------------
Last Update Date | 06/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 QUARRY RD
-----------------------------------------------------
City | PALO ALTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94304-1419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-683-0703
-----------------------------------------------------
Fax | 804-964-2330
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 28 GEARY ST STE 650 #1717
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-683-0703
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | A178845
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------