MEDICARE: DR. DOAN-THY VU DINH D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	30495	CA

General Provider Information

NPI Number	:	1023297603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOAN-THY VU DINH D.C.

Provider Business Mailing Address
First Line	:	225 KALMIA ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-1517
Country	:	US
Telephone Number	:	619-384-0203
Fax Number	:

Provider Business Practice Location Address
First Line	:	2722 5TH AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-6329
Country	:	US
Telephone Number	:	619-688-6522
Fax Number	:	619-688-9743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2007
Last Update Date	:	10/30/2007

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