MEDICARE: THANH DINH OT(CALIFORNIA)

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	225X00000X	Occupational Therapist	26685	CA

General Provider Information

NPI Number	:	1093174013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THANH DINH OT(CALIFORNIA)

Provider Business Mailing Address
First Line	:	1912 VICKI LN
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523
Country	:	US
Telephone Number	:	415-395-6432
Fax Number	:

Provider Business Practice Location Address
First Line	:	6215 FERRIS SQUARE, SAN DIEGO CA 92121
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121
Country	:	US
Telephone Number	:	800-683-1209
Fax Number	:

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

Provider Enumeration Date	:	02/18/2016
Last Update Date	:	08/11/2025

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